Provider Demographics
NPI:1821693813
Name:AKMOOSH, MOHAMMED MANSOUR
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:MANSOUR
Last Name:AKMOOSH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24805 112TH AVE SE APT 3
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-6666
Mailing Address - Country:US
Mailing Address - Phone:253-487-9704
Mailing Address - Fax:
Practice Address - Street 1:24805 112TH AVE SE APT 3
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6666
Practice Address - Country:US
Practice Address - Phone:253-487-9704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter