Provider Demographics
NPI:1962036947
Name:MOHAMEDALI, FATEMA SHABBIR
Entity Type:Individual
Prefix:MS
First Name:FATEMA
Middle Name:SHABBIR
Last Name:MOHAMEDALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11607 98TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4216
Mailing Address - Country:US
Mailing Address - Phone:425-825-8841
Mailing Address - Fax:425-821-7310
Practice Address - Street 1:11607 98TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4216
Practice Address - Country:US
Practice Address - Phone:425-825-8841
Practice Address - Fax:425-821-7310
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIR61039587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist