OrganizationActive
Eastern State Hospital Pharmacy
NPI 1679651970 · Long Term Care Pharmacy · Medical Lake, WA
Provider details
- NPI number
- 1679651970
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Ronda Kenney, Chief Operating Officer(509) 565-4659
Specialties & taxonomies
Suppliers
- Psychiatric Hospital283Q00000X
Hospitals
Practice location
800 West Maple Street
Medical Lake, WA 99022-0800
Phone: (509) 299-3121
Fax: (509) 299-7015
Approximate (ZIP-level) locationGet directions
Mailing address
850 Maple Street
Medical Lake, WA 99022
Registry dates
- Enumerated
- 2006-11-02
- Last updated
- 2018-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.