Provider Demographics
NPI:1841408218
Name:WITEK, DONALD JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:JOSEPH
Last Name:WITEK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 PARK PL
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2024
Mailing Address - Country:US
Mailing Address - Phone:425-252-1750
Mailing Address - Fax:
Practice Address - Street 1:10116 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4148
Practice Address - Country:US
Practice Address - Phone:425-990-2453
Practice Address - Fax:425-990-2444
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00014351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist