Provider Demographics
NPI:1053934893
Name:WOGER, YOSEF HAILU (PHARMD)
Entity type:Individual
Prefix:DR
First Name:YOSEF
Middle Name:HAILU
Last Name:WOGER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25605 104TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7609
Mailing Address - Country:US
Mailing Address - Phone:206-813-6968
Mailing Address - Fax:
Practice Address - Street 1:25605 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7609
Practice Address - Country:US
Practice Address - Phone:206-813-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61053397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist