Provider Demographics
NPI:1720380397
Name:KARASEK, BLANKA (RPH)
Entity Type:Individual
Prefix:
First Name:BLANKA
Middle Name:
Last Name:KARASEK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17023 SE 272ND ST.
Mailing Address - Street 2:SAFEWAY PHARMACY
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042
Mailing Address - Country:US
Mailing Address - Phone:253-631-2450
Mailing Address - Fax:253-631-2451
Practice Address - Street 1:17023 SE 272ND ST.
Practice Address - Street 2:SAFEWAY PHARMACY
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042
Practice Address - Country:US
Practice Address - Phone:253-631-2450
Practice Address - Fax:253-631-2451
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00018841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist