Provider Demographics
NPI:1114612280
Name:AL-HAWASLI, FARAH (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:AL-HAWASLI
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25505 157TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4161
Mailing Address - Country:US
Mailing Address - Phone:206-778-5829
Mailing Address - Fax:
Practice Address - Street 1:25505 157TH AVE SE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4161
Practice Address - Country:US
Practice Address - Phone:206-778-5829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered