Provider Demographics
NPI:1518395177
Name:ALI, AMRO (PH60341881)
Entity Type:Individual
Prefix:
First Name:AMRO
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:PH60341881
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 S 60TH AVE
Mailing Address - Street 2:APT C
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3501
Mailing Address - Country:US
Mailing Address - Phone:414-739-8620
Mailing Address - Fax:
Practice Address - Street 1:5606 SUMMITVIEW AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3038
Practice Address - Country:US
Practice Address - Phone:509-965-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60341881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist