Provider Demographics
NPI:1942339627
Name:JAFARZADEH, SALOME (PHARMD)
Entity Type:Individual
Prefix:
First Name:SALOME
Middle Name:
Last Name:JAFARZADEH
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 1:19401 40TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19401 40TH AVE W STE 330
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5600
Practice Address - Country:US
Practice Address - Phone:800-766-0122
Practice Address - Fax:866-825-5848
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2010-02-16
Deactivation Date:2009-09-10
Deactivation Code:
Reactivation Date:2010-01-21
Provider Licenses
StateLicense IDTaxonomies
WAPH00058917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist