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NPI Code Detail

MEDICARE: DR. LWAM DORI EKUBAZGI PHARMACIST

MEDICARE: DR. LWAM DORI EKUBAZGI PHARMACIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH61058596WA

General Provider Information

NPI Number : 1720694144
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LWAM DORI EKUBAZGI PHARMACIST
Provider Business Mailing Address
First Line : 5900 37TH AVE S APT H42
Second Line :
City : SEATTLE
State : WA
Zip : 98118-6234
Country : US
Telephone Number : 206-383-0506
Fax Number :
Provider Business Practice Location Address
First Line : 5900 37TH AVE S APT H42
Second Line :
City : SEATTLE
State : WA
Zip : 98118-6234
Country : US
Telephone Number : 206-383-0506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2020
Last Update Date : 09/21/2020

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