Provider Demographics
NPI:1033419510
Name:HASSANEIN, SAMAH OMAR (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SAMAH
Middle Name:OMAR
Last Name:HASSANEIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 228TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-7241
Mailing Address - Country:US
Mailing Address - Phone:425-868-4000
Mailing Address - Fax:428-868-2657
Practice Address - Street 1:630 228TH AVE NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7241
Practice Address - Country:US
Practice Address - Phone:425-868-6181
Practice Address - Fax:425-868-2657
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00049037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist