Healthcare Provider Details

I. General information

NPI: 1417810128
Provider Name (Legal Business Name): ABDUL ZAHIR FAQIRZADA SR. VA70009272
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W JAMES PL APT 2A05
KENT WA
98032-4335
US

IV. Provider business mailing address

1600 W JAMES PL APT 2A05
KENT WA
98032-4335
US

V. Phone/Fax

Practice location:
  • Phone: 206-758-1222
  • Fax:
Mailing address:
  • Phone: 206-758-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberVA70009272
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: