Provider Demographics
NPI:1720412315
Name:ROST, RAQUEL MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:MARIE
Last Name:ROST
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 1:17700 NE 76TH ST
Mailing Address - Street 2:T-0995
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3300
Mailing Address - Country:US
Mailing Address - Phone:425-556-9533
Mailing Address - Fax:
Practice Address - Street 1:17700 NE 76TH ST
Practice Address - Street 2:T-0995
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3300
Practice Address - Country:US
Practice Address - Phone:425-556-9533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60387122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist