Healthcare Provider Details

I. General information

NPI: 1114265394
Provider Name (Legal Business Name): ZILLEHUMA SHAKIR PH60266122
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 1ST AVE S
BURIEN WA
98168-3400
US

IV. Provider business mailing address

23606 105TH PL SE
KENT WA
98031-3354
US

V. Phone/Fax

Practice location:
  • Phone: 206-433-6446
  • Fax: 206-433-6464
Mailing address:
  • Phone: 206-290-1319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH60266122
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: