Provider Demographics
NPI:1497031918
Name:SHAHKARAMI, SEAN M (RPH)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:M
Last Name:SHAHKARAMI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 19TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4256
Mailing Address - Country:US
Mailing Address - Phone:425-321-0025
Mailing Address - Fax:425-379-7489
Practice Address - Street 1:10200 19TH AVE SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-4256
Practice Address - Country:US
Practice Address - Phone:425-321-0025
Practice Address - Fax:425-379-7489
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00019577183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist