Provider Demographics
NPI:1699496331
Name:HARDAWAY, LAURA LYNICE (PHARM D)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNICE
Last Name:HARDAWAY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14417 107TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-9413
Mailing Address - Country:US
Mailing Address - Phone:206-819-8201
Mailing Address - Fax:
Practice Address - Street 1:10020 NE 137TH ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-5221
Practice Address - Country:US
Practice Address - Phone:425-821-0708
Practice Address - Fax:425-820-6442
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61331434183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist