Provider Demographics
NPI:1477853737
Name:SABZEVARI, FARZANEH
Entity Type:Individual
Prefix:
First Name:FARZANEH
Middle Name:
Last Name:SABZEVARI
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 1:11031 19TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-5144
Mailing Address - Country:US
Mailing Address - Phone:425-337-0684
Mailing Address - Fax:425-337-0880
Practice Address - Street 1:11031 19TH AVE SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-5144
Practice Address - Country:US
Practice Address - Phone:425-337-0684
Practice Address - Fax:425-337-0880
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00017814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist