Provider Demographics
NPI:1104554229
Name:ARQUILETA, GIOVANNI PAOLO
Entity type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:PAOLO
Last Name:ARQUILETA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13831 NE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3484
Mailing Address - Country:US
Mailing Address - Phone:425-518-5721
Mailing Address - Fax:
Practice Address - Street 1:8862 161ST AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7553
Practice Address - Country:US
Practice Address - Phone:425-883-9532
Practice Address - Fax:425-882-2743
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA61109212183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician