Provider Demographics
NPI:1184468894
Name:MCDERMOTT-GROSSMAN, GARBO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GARBO
Middle Name:
Last Name:MCDERMOTT-GROSSMAN
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 1:3734 BURKE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8339
Mailing Address - Country:US
Mailing Address - Phone:310-367-9376
Mailing Address - Fax:
Practice Address - Street 1:400 E PINE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2316
Practice Address - Country:US
Practice Address - Phone:206-641-7766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61565803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist