Provider Demographics
NPI:1548523483
Name:MAZHARI, AMITRIS (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMITRIS
Middle Name:
Last Name:MAZHARI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2636 BELLEVUE WAY NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-576-9222
Mailing Address - Fax:425-576-9199
Practice Address - Street 1:2636 BELLEVUE WAY NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2209
Practice Address - Country:US
Practice Address - Phone:425-576-9222
Practice Address - Fax:425-576-9199
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00051890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1548523483OtherNPI