1336203975 NPI number — DR. KARIM T ABDULLAH N.D.

Table of content: DR. KARIM T ABDULLAH N.D. (NPI 1336203975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336203975 NPI number — DR. KARIM T ABDULLAH N.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABDULLAH
Provider First Name:
KARIM
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
N.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ABDULLAH
Provider Other First Name:
KARIM
Provider Other Middle Name:
T
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.AC.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1336203975
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15455 SE 47TH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98006-3268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-261-0505
Provider Business Mailing Address Fax Number:
206-524-5054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6300 9TH AVE NE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98115-8515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-522-5646
Provider Business Practice Location Address Fax Number:
206-524-5054
Provider Enumeration Date:
12/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC00002426 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 175F00000X , with the licence number: NT00000767 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7920AB . This is a "REGENCE BLUE SHIELD RIDER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 2426AB . This is a "REGENCE BLUE SHIELD RIDER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 5096622 . This is a "AETNA PROVIDER ID" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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