Provider Demographics
NPI:1093417545
Name:ALI, SHAMSO SAEED (NONE)
Entity Type:Individual
Prefix:
First Name:SHAMSO
Middle Name:SAEED
Last Name:ALI
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9801 130TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-9143
Mailing Address - Country:US
Mailing Address - Phone:253-228-3138
Mailing Address - Fax:
Practice Address - Street 1:9801 130TH STREET CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-9143
Practice Address - Country:US
Practice Address - Phone:253-228-3138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other