Provider Demographics
NPI:1750137162
Name:GIRGIS, MARIAM ADEL MICHAEL TAWFIK (PHARMACIST)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:ADEL MICHAEL TAWFIK
Last Name:GIRGIS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 156TH ST SW APT G105
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-8428
Mailing Address - Country:US
Mailing Address - Phone:206-581-9189
Mailing Address - Fax:
Practice Address - Street 1:23028 100TH AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-5080
Practice Address - Country:US
Practice Address - Phone:425-670-2860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61526030183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist