Provider Demographics
NPI:1679892772
Name:MERCHANT, IMRAN ARIFF (RPH)
Entity Type:Individual
Prefix:
First Name:IMRAN
Middle Name:ARIFF
Last Name:MERCHANT
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 1:22631 BOTHELL EVERETT HWY
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-8401
Mailing Address - Country:US
Mailing Address - Phone:425-481-8667
Mailing Address - Fax:425-402-0650
Practice Address - Street 1:22631 BOTHELL EVERETT HWY
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-8401
Practice Address - Country:US
Practice Address - Phone:425-481-8667
Practice Address - Fax:425-402-0650
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00042182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist