Provider Demographics
NPI:1376275974
Name:KASHIF, SUBUL (IR60810219)
Entity type:Individual
Prefix:MRS
First Name:SUBUL
Middle Name:
Last Name:KASHIF
Suffix:
Gender:F
Credentials:IR60810219
Other - Prefix:MRS
Other - First Name:SUBUL
Other - Middle Name:
Other - Last Name:KASHIF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IR60810219
Mailing Address - Street 1:12817 ODESSA DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-2395
Mailing Address - Country:US
Mailing Address - Phone:604-445-1872
Mailing Address - Fax:
Practice Address - Street 1:1195 BOBLETT ST
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230-4062
Practice Address - Country:US
Practice Address - Phone:360-332-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIR60810219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty