Provider Demographics
NPI:1922672443
Name:ARNOLD, DEVIN BLACK (CPHT)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:BLACK
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 24TH AVE E APT 303
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5469
Mailing Address - Country:US
Mailing Address - Phone:408-802-3059
Mailing Address - Fax:
Practice Address - Street 1:5409 15TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3810
Practice Address - Country:US
Practice Address - Phone:206-781-0056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCH175135183700000X
WAVA61519543183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Multi-Specialty