Provider Demographics
NPI:1255665329
Name:SHARMA, NEETU
Entity Type:Individual
Prefix:
First Name:NEETU
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 S 188TH ST APT 104
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-5213
Mailing Address - Country:US
Mailing Address - Phone:206-248-4314
Mailing Address - Fax:
Practice Address - Street 1:2600 SW BARTON ST
Practice Address - Street 2:H1
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3948
Practice Address - Country:US
Practice Address - Phone:206-938-4253
Practice Address - Fax:206-932-0610
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60028495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist