Healthcare Provider Details

I. General information

NPI: 1871721886
Provider Name (Legal Business Name): HASHEM EMAD RIFAAT RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WASHINGTON AVE N
KENT WA
98032-4438
US

IV. Provider business mailing address

105 WASHINGTON AVE N
KENT WA
98032-4438
US

V. Phone/Fax

Practice location:
  • Phone: 253-373-0156
  • Fax: 253-373-1308
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH 60011671
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: