Provider Demographics
NPI:1285964973
Name:MOCK, ANNE MARIE MARIKO (PHARMD)
Entity type:Individual
Prefix:MS
First Name:ANNE MARIE
Middle Name:MARIKO
Last Name:MOCK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 15TH AVE NW STE A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3665
Mailing Address - Country:US
Mailing Address - Phone:206-706-5210
Mailing Address - Fax:206-706-5679
Practice Address - Street 1:8500 15TH AVE NW STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3665
Practice Address - Country:US
Practice Address - Phone:206-706-5210
Practice Address - Fax:206-706-5679
Is Sole Proprietor?:No
Enumeration Date:2010-01-03
Last Update Date:2010-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60017265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist