Provider Demographics
NPI:1770623845
Name:GRAMBO, KATHRYN R (RPH)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:R
Last Name:GRAMBO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:R
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:3810 S STAR LAKE RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-1322
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2921 NACHES AVE SW
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2617
Practice Address - Country:US
Practice Address - Phone:206-630-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00043093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist