Provider Demographics
NPI:1184924896
Name:SWEIDAN, HUSAM AMJAD (PHARMD)
Entity type:Individual
Prefix:
First Name:HUSAM
Middle Name:AMJAD
Last Name:SWEIDAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 E MEAD AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98903-3721
Mailing Address - Country:US
Mailing Address - Phone:509-248-8782
Mailing Address - Fax:509-248-6425
Practice Address - Street 1:905 E MEAD AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98903-3721
Practice Address - Country:US
Practice Address - Phone:509-248-8782
Practice Address - Fax:509-248-6425
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60176718183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist