Provider Demographics
NPI:1013238922
Name:BERHE, YONAS
Entity Type:Individual
Prefix:
First Name:YONAS
Middle Name:
Last Name:BERHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13201 AURORA AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-7584
Mailing Address - Country:US
Mailing Address - Phone:206-364-7676
Mailing Address - Fax:206-367-2596
Practice Address - Street 1:13201 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-7584
Practice Address - Country:US
Practice Address - Phone:206-364-7676
Practice Address - Fax:206-367-2596
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00050742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist