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General NPI Number Information
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NPI Number | 1568920734
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Entity Type | Individual
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Provider Name | SHADI GHAIBI PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/06/2019
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Last Update Date | 03/06/2019
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Provider Practice Location Address
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Address Line | 2921 NACHES AVE SW
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City | RENTON
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State | WA
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Zip | 98057-2617
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Country | US
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Telephone | 206-630-1007
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Fax |
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Provider Business Mailing Address
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Address Line | 3308 SW CHARLESTOWN ST
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City | SEATTLE
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State | WA
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Zip | 98126-2527
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Country | US
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Telephone | 801-599-5481
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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 | PH60803170
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License Number State | WA
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