Provider Demographics
NPI:1295314805
Name:BAH, FATIMATOU (MD, MS, MPH)
Entity type:Individual
Prefix:
First Name:FATIMATOU
Middle Name:
Last Name:BAH
Suffix:
Gender:F
Credentials:MD, MS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 16TH AVE E # CHS545
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5211
Mailing Address - Country:US
Mailing Address - Phone:206-326-3585
Mailing Address - Fax:877-673-4188
Practice Address - Street 1:125 16TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5211
Practice Address - Country:US
Practice Address - Phone:206-326-3585
Practice Address - Fax:877-673-4188
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61549601207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine