MEDICARE: SONU BOHRA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH6066242	WA

General Provider Information

NPI Number	:	1639618002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONU BOHRA

Provider Business Mailing Address
First Line	:	PO BOX 5127
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98206-5127
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 41ST ST
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98203-2355
Country	:	US
Telephone Number	:	425-259-1180
Fax Number	:	425-259-1172

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2017
Last Update Date	:	01/20/2021

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Directions to “ SONU BOHRA ” Practice Location

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