Provider Demographics
NPI:1841754041
Name:ALI, HANA (PMNP -BC, RN)
Entity Type:Individual
Prefix:
First Name:HANA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:PMNP -BC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 KIRKLAND AVE NE APT A
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-3294
Mailing Address - Country:US
Mailing Address - Phone:360-584-0111
Mailing Address - Fax:
Practice Address - Street 1:1314 CENTRAL AVE S STE 203
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-7430
Practice Address - Country:US
Practice Address - Phone:360-584-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61514511363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health