Provider Demographics
NPI:1477191856
Name:MESSELE, GETENET M (PHARMD)
Entity Type:Individual
Prefix:
First Name:GETENET
Middle Name:M
Last Name:MESSELE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3469 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1651
Mailing Address - Country:US
Mailing Address - Phone:206-228-6695
Mailing Address - Fax:
Practice Address - Street 1:1300 W F ST
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-3501
Practice Address - Country:US
Practice Address - Phone:209-847-1324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH81668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist