Provider Demographics
NPI:1780971580
Name:PATEL, AMISHA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMISHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13950 NE 178TH PL
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-3523
Mailing Address - Country:US
Mailing Address - Phone:425-492-1820
Mailing Address - Fax:425-492-1897
Practice Address - Street 1:13950 NE 178TH PL
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-3523
Practice Address - Country:US
Practice Address - Phone:425-492-1820
Practice Address - Fax:425-492-1897
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00041611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist