Healthcare Provider Details

I. General information

NPI: 1679892772
Provider Name (Legal Business Name): IMRAN ARIFF MERCHANT RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22631 BOTHELL EVERETT HWY
BOTHELL WA
98021-8401
US

IV. Provider business mailing address

22631 BOTHELL EVERETT HWY
BOTHELL WA
98021-8401
US

V. Phone/Fax

Practice location:
  • Phone: 425-481-8667
  • Fax: 425-402-0650
Mailing address:
  • Phone: 425-481-8667
  • Fax: 425-402-0650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00042182
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: