Provider Demographics
NPI:1255036125
Name:HUSSIEN, ABUBEKER
Entity type:Individual
Prefix:
First Name:ABUBEKER
Middle Name:
Last Name:HUSSIEN
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 1:20926 109TH PL SE APT 1707
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-1105
Mailing Address - Country:US
Mailing Address - Phone:703-639-8177
Mailing Address - Fax:
Practice Address - Street 1:20926 109TH PL SE APT 1707
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-1105
Practice Address - Country:US
Practice Address - Phone:703-639-8177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61418626363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health