Provider Demographics
NPI:1871993915
Name:EILERS, NATHAN M (RPH)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:M
Last Name:EILERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8990
Mailing Address - Country:US
Mailing Address - Phone:425-416-4579
Mailing Address - Fax:
Practice Address - Street 1:999 LAKE DR
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8990
Practice Address - Country:US
Practice Address - Phone:425-416-4579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60094346183500000X
ORRPH-0009110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist