Provider Demographics
NPI:1326817941
Name:ALI, ALI FATHI
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:FATHI
Last Name:ALI
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 1:307 PIKE ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-5832
Mailing Address - Country:US
Mailing Address - Phone:253-545-8886
Mailing Address - Fax:
Practice Address - Street 1:307 PIKE ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5832
Practice Address - Country:US
Practice Address - Phone:253-545-8886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst