Provider Demographics
NPI:1407579451
Name:SHAABAN, NABEEL
Entity Type:Individual
Prefix:
First Name:NABEEL
Middle Name:
Last Name:SHAABAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MO
Other - Middle Name:
Other - Last Name:SHAABAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 KERR PKWY APT 35
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-1473
Mailing Address - Country:US
Mailing Address - Phone:971-335-4744
Mailing Address - Fax:
Practice Address - Street 1:1720 S GOLD ST
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-8951
Practice Address - Country:US
Practice Address - Phone:360-261-6930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist