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General NPI Number Information
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NPI Number | 1740772565
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Entity Type | Individual
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Provider Name | MARYAM HORMATI PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 1600 E OLIVE ST
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City | SEATTLE
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State | WA
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Zip | 98122-2735
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Country | US
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Telephone | 425-835-7110
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Fax | 206-971-2991
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Provider Business Mailing Address
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Address Line | 224B 12TH AVE E
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City | SEATTLE
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State | WA
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Zip | 98102-5806
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Country | US
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Telephone | 206-641-0964
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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 | 60257341
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License Number State | WA
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