Provider Demographics
NPI:1154581593
Name:MA, HANA (RPH)
Entity type:Individual
Prefix:
First Name:HANA
Middle Name:
Last Name:MA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 BELMONT AVE
Mailing Address - Street 2:APT. 610
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-8300
Mailing Address - Country:US
Mailing Address - Phone:425-225-5618
Mailing Address - Fax:
Practice Address - Street 1:17615 140TH AVE SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-6828
Practice Address - Country:US
Practice Address - Phone:425-204-1585
Practice Address - Fax:425-204-0743
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00068831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist