Provider Demographics
NPI:1578031266
Name:OSMAN, MUNA IBRAHIM (DNP FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:MUNA
Middle Name:IBRAHIM
Last Name:OSMAN
Suffix:
Gender:F
Credentials:DNP FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 M ST NE STE 105
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4503
Mailing Address - Country:US
Mailing Address - Phone:253-766-1161
Mailing Address - Fax:253-804-5655
Practice Address - Street 1:721 M ST NE STE 105
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4503
Practice Address - Country:US
Practice Address - Phone:253-766-1161
Practice Address - Fax:253-804-5565
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-12
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAPAP6363LF0000X
WAAP60745947363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty