Provider Demographics
NPI:1720694144
Name:EKUBAZGI, LWAM DORI (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:LWAM
Middle Name:DORI
Last Name:EKUBAZGI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:LUWAN
Other - Middle Name:DORI
Other - Last Name:EKUBAZGI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:5900 37TH AVE S APT H42
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6234
Mailing Address - Country:US
Mailing Address - Phone:206-383-0506
Mailing Address - Fax:
Practice Address - Street 1:5900 37TH AVE S APT H42
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-6234
Practice Address - Country:US
Practice Address - Phone:206-383-0506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61058596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist