Provider Demographics
NPI:1952674053
Name:HASSAN, FARHIA MOHAMED (RPH)
Entity Type:Individual
Prefix:
First Name:FARHIA
Middle Name:MOHAMED
Last Name:HASSAN
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 1:17801 108TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6423
Mailing Address - Country:US
Mailing Address - Phone:425-235-5383
Mailing Address - Fax:425-235-5392
Practice Address - Street 1:17801 108TH AVE SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6423
Practice Address - Country:US
Practice Address - Phone:425-235-5383
Practice Address - Fax:425-235-5392
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00065946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist