Provider Demographics
NPI:1063712768
Name:LAIB, KIRSTIN M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KIRSTIN
Middle Name:M
Last Name:LAIB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:19150 NE WOODINVILLE DUVALL RD
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-9477
Mailing Address - Country:US
Mailing Address - Phone:425-788-6658
Mailing Address - Fax:425-788-4391
Practice Address - Street 1:19150 NE WOODINVILLE DUVALL RD
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-9477
Practice Address - Country:US
Practice Address - Phone:425-788-6658
Practice Address - Fax:425-788-4391
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA21953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist