Provider Demographics
NPI:1770619918
Name:NANJI, AMIN MOHAMED
Entity type:Individual
Prefix:MR
First Name:AMIN
Middle Name:MOHAMED
Last Name:NANJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 NORTHWEST AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-9083
Mailing Address - Country:US
Mailing Address - Phone:360-510-6626
Mailing Address - Fax:
Practice Address - Street 1:220 36TH ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6540
Practice Address - Country:US
Practice Address - Phone:360-734-8254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH41989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist