Provider Demographics
NPI:1013051234
Name:DRAWBAUGH, KIRBY A (RPH)
Entity Type:Individual
Prefix:MR
First Name:KIRBY
Middle Name:A
Last Name:DRAWBAUGH
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 1:18360 W LAKE DESIRE DR SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9568
Mailing Address - Country:US
Mailing Address - Phone:206-909-6397
Mailing Address - Fax:
Practice Address - Street 1:18360 W LAKE DESIRE DR SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-9568
Practice Address - Country:US
Practice Address - Phone:206-909-6397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist