Provider Demographics
NPI:1457826745
Name:MEHTA, BIJAL (PHARM D)
Entity Type:Individual
Prefix:
First Name:BIJAL
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
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 1:2349 YALE AVE E APT 6
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3336
Mailing Address - Country:US
Mailing Address - Phone:281-876-7371
Mailing Address - Fax:
Practice Address - Street 1:2035 4TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2414
Practice Address - Country:US
Practice Address - Phone:206-448-2002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60844160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist