Provider Demographics
NPI:1760702344
Name:YABALURI, SOWMYA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SOWMYA
Middle Name:
Last Name:YABALURI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14035 NE WOODINVILLE DUVALL RD
Mailing Address - Street 2:RITE AID 5205
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8504
Mailing Address - Country:US
Mailing Address - Phone:425-485-6468
Mailing Address - Fax:425-481-1902
Practice Address - Street 1:14035 NE WOODINVILLE DUVALL RD
Practice Address - Street 2:RITE AID 5205
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-8504
Practice Address - Country:US
Practice Address - Phone:425-485-6468
Practice Address - Fax:425-481-1902
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00067966183500000X
NH3340183500000X
MD16826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist