Provider Demographics
NPI:1821647694
Name:GAD, EKRAM A
Entity Type:Individual
Prefix:
First Name:EKRAM
Middle Name:A
Last Name:GAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EKRAM
Other - Middle Name:A
Other - Last Name:MAKARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5628 158TH ST SW
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-4634
Mailing Address - Country:US
Mailing Address - Phone:425-772-6634
Mailing Address - Fax:
Practice Address - Street 1:5628 158TH ST SW
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-4634
Practice Address - Country:US
Practice Address - Phone:425-772-6634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA4828171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter