Provider Demographics
NPI:1174869598
Name:HUTCHINSON, JEREMY GAGE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:GAGE
Last Name:HUTCHINSON
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 1:1500 NW MARKET ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5211
Mailing Address - Country:US
Mailing Address - Phone:954-612-5070
Mailing Address - Fax:
Practice Address - Street 1:1500 NW MARKET ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5211
Practice Address - Country:US
Practice Address - Phone:954-612-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2014-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45616183500000X
WAPH60292403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist