Provider Demographics
NPI:1528292489
Name:SANJINES, EVA (PHARMACIST)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:SANJINES
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 ISSAQUAH PINE LAKE RD SE
Mailing Address - Street 2:RITE AID 5188
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-7253
Mailing Address - Country:US
Mailing Address - Phone:425-391-1582
Mailing Address - Fax:425-391-8361
Practice Address - Street 1:3066 ISSAQUAH PINE LAKE RD SE
Practice Address - Street 2:RITE AID 5188
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-7253
Practice Address - Country:US
Practice Address - Phone:425-391-1582
Practice Address - Fax:425-391-8361
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00039175183500000X
CARPH49391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist