Provider Demographics
NPI:1336992064
Name:AIGBUZA, ESEOSA OSARENOMA (PHARMD)
Entity type:Individual
Prefix:
First Name:ESEOSA
Middle Name:OSARENOMA
Last Name:AIGBUZA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ESSIE
Other - Middle Name:
Other - Last Name:AIGBUZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4302 7TH AVE NE APT 308
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-6674
Mailing Address - Country:US
Mailing Address - Phone:510-338-8700
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:510-338-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID316379183500000X
CA89901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist