Provider Demographics
NPI:1750658662
Name:ELHALABY, SALIM (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SALIM
Middle Name:
Last Name:ELHALABY
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 PIEDMONT RD NE STE 56-151
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3086
Mailing Address - Country:US
Mailing Address - Phone:470-572-4342
Mailing Address - Fax:
Practice Address - Street 1:555 SE MARTIN LUTHER KING JR BLVD STE 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2120
Practice Address - Country:US
Practice Address - Phone:503-664-9451
Practice Address - Fax:503-386-3230
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-20
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN227176363L00000X
WAAP61321680363LP0808X
OR202210765NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner