Provider Demographics
NPI:1316588619
Name:MOUSTAPHA, ALIMATOU (ARNP, PMHNP)
Entity Type:Individual
Prefix:MS
First Name:ALIMATOU
Middle Name:
Last Name:MOUSTAPHA
Suffix:
Gender:F
Credentials:ARNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26236 33RD AVE S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-7055
Mailing Address - Country:US
Mailing Address - Phone:206-683-0540
Mailing Address - Fax:
Practice Address - Street 1:9601 STEILACOOM BLVD SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-7212
Practice Address - Country:US
Practice Address - Phone:253-582-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60702851363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health