Provider Demographics
NPI:1003366782
Name:ABU, ABERA GELETO (PHARM D)
Entity Type:Individual
Prefix:
First Name:ABERA
Middle Name:GELETO
Last Name:ABU
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:ABERA
Other - Middle Name:GELETO
Other - Last Name:ABU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:12607 SE MILL PLAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6055
Mailing Address - Country:US
Mailing Address - Phone:360-449-1600
Mailing Address - Fax:360-896-4467
Practice Address - Street 1:12607 SE MILL PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6055
Practice Address - Country:US
Practice Address - Phone:360-449-1600
Practice Address - Fax:360-896-4467
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00101131835P0018X
WAPH000472451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist