Provider Demographics
NPI:1356775084
Name:CLINCH, TERENCE M (RPH)
Entity type:Individual
Prefix:
First Name:TERENCE
Middle Name:M
Last Name:CLINCH
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 1:25304 NE 3RD PL
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-3458
Mailing Address - Country:US
Mailing Address - Phone:425-890-3082
Mailing Address - Fax:
Practice Address - Street 1:25304 NE 3RD PL
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-3458
Practice Address - Country:US
Practice Address - Phone:425-890-3082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA15006183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist