Provider Demographics
NPI:1205546439
Name:KAHSAY, HADDISH (PHARMD)
Entity type:Individual
Prefix:
First Name:HADDISH
Middle Name:
Last Name:KAHSAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 N 194TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4141
Mailing Address - Country:US
Mailing Address - Phone:206-397-2142
Mailing Address - Fax:
Practice Address - Street 1:3716 S 144TH ST
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4045
Practice Address - Country:US
Practice Address - Phone:206-204-1284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60987584183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist