Provider Demographics
NPI:1912481268
Name:HANNA, RIMON SAMIR FAHMY (PHARMD)
Entity Type:Individual
Prefix:
First Name:RIMON
Middle Name:SAMIR FAHMY
Last Name:HANNA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 S 23RD ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4206
Mailing Address - Country:US
Mailing Address - Phone:508-250-7808
Mailing Address - Fax:
Practice Address - Street 1:708 S 23RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4206
Practice Address - Country:US
Practice Address - Phone:508-250-7808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-22
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60860235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist