Provider Demographics
NPI:1841590122
Name:COX, KEN A (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEN
Middle Name:A
Last Name:COX
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 1:4831 POINT FOSDICK DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1732
Mailing Address - Country:US
Mailing Address - Phone:253-851-6870
Mailing Address - Fax:253-858-4973
Practice Address - Street 1:4831 POINT FOSDICK DR NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1732
Practice Address - Country:US
Practice Address - Phone:253-851-6870
Practice Address - Fax:253-858-4973
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00019955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist