Provider Demographics
NPI:1972355642
Name:SUMAR, MISBAH
Entity Type:Individual
Prefix:
First Name:MISBAH
Middle Name:
Last Name:SUMAR
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 1:4250 W LAKE SAMMAMISH PKWY NE APT E1027
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5680
Mailing Address - Country:US
Mailing Address - Phone:206-471-0593
Mailing Address - Fax:
Practice Address - Street 1:704 228TH AVE NE # 931
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7222
Practice Address - Country:US
Practice Address - Phone:425-428-7517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling