Provider Demographics
NPI:1932176419
Name:MERK, ELIZABETH SUSAN (RPH)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:SUSAN
Last Name:MERK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13116 SE 26TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-4457
Mailing Address - Country:US
Mailing Address - Phone:425-649-5099
Mailing Address - Fax:
Practice Address - Street 1:13116 SE 26TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-4457
Practice Address - Country:US
Practice Address - Phone:425-649-5099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00010050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH00010050OtherPHARMACIST LICENSE