Provider Demographics
NPI:1497470959
Name:TAHOUN, DIAA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DIAA
Middle Name:
Last Name:TAHOUN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14820 REDMOND WAY APT 128
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4259
Mailing Address - Country:US
Mailing Address - Phone:415-617-5317
Mailing Address - Fax:
Practice Address - Street 1:8862 161ST AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7553
Practice Address - Country:US
Practice Address - Phone:426-883-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIR61300503390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program