Provider Demographics
NPI:1942815436
Name:ALI, AMMAR HASSAN
Entity Type:Individual
Prefix:
First Name:AMMAR
Middle Name:HASSAN
Last Name:ALI
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 1:1201 S 336TH ST APT K105
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6054
Mailing Address - Country:US
Mailing Address - Phone:206-787-0338
Mailing Address - Fax:
Practice Address - Street 1:1201 S 336TH ST APT K105
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6054
Practice Address - Country:US
Practice Address - Phone:206-787-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA2405171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty