Provider Demographics
NPI:1710262415
Name:STARSKY, TIMOTHY A (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:A
Last Name:STARSKY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23747 42ND AVE SE
Mailing Address - Street 2:37A
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7793
Mailing Address - Country:US
Mailing Address - Phone:585-419-5267
Mailing Address - Fax:
Practice Address - Street 1:608 W STANLEY ST
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:WA
Practice Address - Zip Code:98252-8476
Practice Address - Country:US
Practice Address - Phone:360-691-4659
Practice Address - Fax:360-691-1487
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60178091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist