Provider Demographics
NPI:1972803724
Name:WHITAKER, KEVIN ALLEN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ALLEN
Last Name:WHITAKER
Suffix:
Gender:M
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 1:301 HIGH SCHOOL RD NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1608
Mailing Address - Country:US
Mailing Address - Phone:206-842-4065
Mailing Address - Fax:206-780-2781
Practice Address - Street 1:301 HIGH SCHOOL RD NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1608
Practice Address - Country:US
Practice Address - Phone:206-842-4065
Practice Address - Fax:206-780-2781
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2025-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00039010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist