Provider Demographics
NPI:1801207972
Name:LAKEY, SUSAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:LAKEY
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 1:6180 NE RADFORD DR
Mailing Address - Street 2:#2012
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7990
Mailing Address - Country:US
Mailing Address - Phone:206-387-2638
Mailing Address - Fax:
Practice Address - Street 1:6180 NE RADFORD DR
Practice Address - Street 2:#2012
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-7990
Practice Address - Country:US
Practice Address - Phone:206-387-2638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00041910183500000X, 1835G0303X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric