Provider Demographics
NPI:1710088745
Name:JOSEPH, JUTTA CECILE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JUTTA
Middle Name:CECILE
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 LAKE WASHINGTON BLVD N
Mailing Address - Street 2:#P302
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-1449
Mailing Address - Country:US
Mailing Address - Phone:425-917-5721
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-762-1010
Practice Address - Fax:206-764-2380
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPH00020665183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist