Basic Information
| Provider Information | |||||||||
| NPI: | 1962036947 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOHAMEDALI | ||||||||
| FirstName: | FATEMA | ||||||||
| MiddleName: | SHABBIR | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11607 98TH AVE NE | ||||||||
| Address2: | |||||||||
| City: | KIRKLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980344216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4258258841 | ||||||||
| FaxNumber: | 4258217310 | ||||||||
| Practice Location | |||||||||
| Address1: | 11607 98TH AVE NE | ||||||||
| Address2: | |||||||||
| City: | KIRKLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980344216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4258258841 | ||||||||
| FaxNumber: | 4258217310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2020 | ||||||||
| LastUpdateDate: | 02/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | IR61039587 | WA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.