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General NPI Number Information
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NPI Number | 1316494024
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Entity Type | Individual
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Provider Name | MANDANA NADERI PHARMD, MPH, BCIDP
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Gender | Female
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Dates
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Enumeration Date | 09/10/2016
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Last Update Date | 03/10/2024
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Provider Practice Location Address
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Address Line | 650 E VAN BUREN ST
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City | PHOENIX
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State | AZ
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Zip | 85004-2222
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Country | US
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Telephone | 602-827-2441
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Fax |
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Provider Business Mailing Address
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Address Line | 860 LINGERING PINE DR NW
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City | ISSAQUAH
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State | WA
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Zip | 98027-5661
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Country | US
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Telephone | 425-577-8267
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Fax |
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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 | RP451044
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License Number State | PA
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