Provider Demographics
NPI:1457783375
Name:ANDERSON, KERRY LYNN (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:LYNN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 2ND AVE
Mailing Address - Street 2:T-2786
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2187
Mailing Address - Country:US
Mailing Address - Phone:206-494-3250
Mailing Address - Fax:206-494-3256
Practice Address - Street 1:1401 2ND AVE
Practice Address - Street 2:T-2786
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2187
Practice Address - Country:US
Practice Address - Phone:206-494-3250
Practice Address - Fax:206-494-3256
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60389148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist