Provider Demographics
NPI:1619684552
Name:HUSSEIN, SALAH ALI II (NURSE AIDE)
Entity Type:Individual
Prefix:
First Name:SALAH
Middle Name:ALI
Last Name:HUSSEIN
Suffix:II
Gender:M
Credentials:NURSE AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17035 53RD AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3251
Mailing Address - Country:US
Mailing Address - Phone:206-593-9180
Mailing Address - Fax:
Practice Address - Street 1:17035 53RD AVE S
Practice Address - Street 2:
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-3251
Practice Address - Country:US
Practice Address - Phone:206-593-9180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHM61208072376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA755906OtherDSHS