Provider Demographics
NPI:1679352983
Name:HASSONA, MOHAMED D HESSEIN (PHARMACIST)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:D HESSEIN
Last Name:HASSONA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 YAKIMA ST APT 301
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-6904
Mailing Address - Country:US
Mailing Address - Phone:604-889-0369
Mailing Address - Fax:
Practice Address - Street 1:470 GRANT RD
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5336
Practice Address - Country:US
Practice Address - Phone:509-886-7047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60251175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist