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General NPI Number Information
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NPI Number | 1053673715
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Entity Type | Individual
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Provider Name | ZEREIT HAILESELASSIE RPH
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Gender | Male
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 1001 MADISON ST STE 150
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City | SEATTLE
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State | WA
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Zip | 98104-1993
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Country | US
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Telephone | 800-619-7610
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Fax | 800-619-7611
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Provider Business Mailing Address
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Address Line | 1001 MADISON ST STE 150
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City | SEATTLE
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State | WA
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Zip | 98104-1993
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Country | US
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Telephone | 800-619-7610
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Fax | 800-619-7611
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 00015709
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 00015709
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 00015709
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License Number State | WA
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