Provider Demographics
NPI:1396133104
Name:LEWIS, KAYE MARIE (PHARM D)
Entity type:Individual
Prefix:
First Name:KAYE
Middle Name:MARIE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-3231
Mailing Address - Country:US
Mailing Address - Phone:206-324-1188
Mailing Address - Fax:206-324-2223
Practice Address - Street 1:4130 E MADISON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-3231
Practice Address - Country:US
Practice Address - Phone:206-324-1188
Practice Address - Fax:206-324-2223
Is Sole Proprietor?:No
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00019389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist