Provider Demographics
NPI:1659879518
Name:SAHELE, TARIKU C (PHARMD)
Entity Type:Individual
Prefix:
First Name:TARIKU
Middle Name:C
Last Name:SAHELE
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 1:14814 29TH AVE W APT A203
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-2466
Mailing Address - Country:US
Mailing Address - Phone:206-422-3519
Mailing Address - Fax:
Practice Address - Street 1:3202 132ND ST SE
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-5624
Practice Address - Country:US
Practice Address - Phone:425-379-7105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60774092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty