John George Fam Abdelmalek
Individual provider Active NPI Pharmacist · Aberdeen, WA
NPI 1881985133 · NPPES record last updated Apr 20, 2011
Key facts
- NPI
- 1881985133
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH60163161 (WA)
- Practice address
- 310 Myrtle St
Aberdeen, WA 98520-4416 - Phone
- (360) 533-5531
- NPI assigned
- Apr 20, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60163161 | WA | MD | Pharmacist |
Interoperability endpoints
- jabdelmalek178638@ghc.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60163161 | WA | Yes |
Addresses
Primary practice location
310 Myrtle St
Aberdeen, WA 98520-4416
Mailing address
975 E Park Ave
Apt 301
Montesano, WA 98563-3922
Other providers in Aberdeen, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.