Provider Demographics
NPI:1629352257
Name:BASSALE, KARIMA RAAD (ND)
Entity Type:Individual
Prefix:DR
First Name:KARIMA
Middle Name:RAAD
Last Name:BASSALE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
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Mailing Address - Street 1:2690 NE KRESKY AVE
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-2412
Mailing Address - Country:US
Mailing Address - Phone:360-330-9595
Mailing Address - Fax:360-330-9560
Practice Address - Street 1:3775 MARTIN WAY E STE A
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5007
Practice Address - Country:US
Practice Address - Phone:360-236-7166
Practice Address - Fax:360-529-8070
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR1833175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANT60807913OtherLICENSE
WA2092622Medicaid