Provider Demographics
NPI:1669969366
Name:EL SAMALUTY, MORSY (RPH)
Entity type:Individual
Prefix:
First Name:MORSY
Middle Name:
Last Name:EL SAMALUTY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9523 NE 180TH ST APT A203
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-7901
Mailing Address - Country:US
Mailing Address - Phone:425-293-6204
Mailing Address - Fax:
Practice Address - Street 1:110 E 3RD ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3010
Practice Address - Country:US
Practice Address - Phone:360-457-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60812040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist