Provider Demographics
NPI:1295591154
Name:AMUNEKE, ESEOSA SOPHIE-ANN (RPH)
Entity type:Individual
Prefix:
First Name:ESEOSA
Middle Name:SOPHIE-ANN
Last Name:AMUNEKE
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 1:12512C 15TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4020
Mailing Address - Country:US
Mailing Address - Phone:516-820-7364
Mailing Address - Fax:
Practice Address - Street 1:15100 SE 38TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1728
Practice Address - Country:US
Practice Address - Phone:425-746-4028
Practice Address - Fax:425-746-3703
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61507209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist