Provider Demographics
NPI:1720046410
Name:HAQ, ALIYA S (RD)
Entity Type:Individual
Prefix:
First Name:ALIYA
Middle Name:S
Last Name:HAQ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 3007
Mailing Address - Street 2:INTERNATIONAL COMMUNITY HEALTH SERVICES
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98114
Mailing Address - Country:US
Mailing Address - Phone:206-788-3612
Mailing Address - Fax:206-652-5216
Practice Address - Street 1:720 8TH AVE S
Practice Address - Street 2:INTERNATIONAL COMMUNITY HEALTH SERVICES
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-788-3612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001057133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0172930OtherL&I PIN
WA8369548Medicaid
WA0172930OtherL&I PIN
WA8369548Medicaid