Healthcare Provider Details

I. General information

NPI: 1831615533
Provider Name (Legal Business Name): AMIR M PIRANFAR PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 NE KRESKY AVE
CHEHALIS WA
98532-2412
US

IV. Provider business mailing address

2690 NE KRESKY AVE
CHEHALIS WA
98532-2412
US

V. Phone/Fax

Practice location:
  • Phone: 360-330-9595
  • Fax:
Mailing address:
  • Phone: 360-330-9595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60769534
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: