Individual
SHENOUDA A KERIACOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4502 E OAK ST, PHOENIX, AZ 85008-2411
(602) 808-0111
Mailing address
10000 MICKELBERRY RD NW, SILVERDALE, WA 98383-8302
(480) 363-5525
(360) 308-2125
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
S017054
AZ
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
PH60631590
WA
Other
Enumeration date
05/14/2013
Last updated
01/27/2020
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