Provider Demographics
NPI:1164202388
Name:SULEMANA, ABDUL-MATIUNE
Entity Type:Individual
Prefix:
First Name:ABDUL-MATIUNE
Middle Name:
Last Name:SULEMANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 839
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98111-0839
Mailing Address - Country:US
Mailing Address - Phone:425-259-3191
Mailing Address - Fax:
Practice Address - Street 1:2802 BROADWAY AVE, EVERETT 98201-3642
Practice Address - Street 2:
Practice Address - City:SETTLE
Practice Address - State:WA
Practice Address - Zip Code:98201-3642
Practice Address - Country:US
Practice Address - Phone:425-259-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health