Provider Demographics
NPI:1942243134
Name:KOZU, R GEOFFREY (PHARMD)
Entity Type:Individual
Prefix:
First Name:R
Middle Name:GEOFFREY
Last Name:KOZU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11326 3RD AVE NE
Mailing Address - Street 2:#203
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6016
Mailing Address - Country:US
Mailing Address - Phone:206-417-9886
Mailing Address - Fax:
Practice Address - Street 1:2700 NE UNIVERSITY VILLAGE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5016
Practice Address - Country:US
Practice Address - Phone:206-525-0705
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00064328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist