Provider Demographics
NPI:1023706215
Name:YOUNES, MOHAMMED (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:
Last Name:YOUNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMED
Other - Middle Name:
Other - Last Name:YOUNES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:825 SE BISHOP BLVD.
Mailing Address - Street 2:STE 401
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163
Mailing Address - Country:US
Mailing Address - Phone:509-336-7720
Mailing Address - Fax:
Practice Address - Street 1:825 SE BISHOP BLVD.
Practice Address - Street 2:STE 401
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163
Practice Address - Country:US
Practice Address - Phone:509-336-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2024-02-27
Deactivation Date:2023-11-29
Deactivation Code:
Reactivation Date:2023-12-07
Provider Licenses
StateLicense IDTaxonomies
WAML61436777207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine