Provider Demographics
NPI:1477371698
Name:OMAR, AHMED M
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:M
Last Name:OMAR
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 1:30613 132ND CT SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-3275
Mailing Address - Country:US
Mailing Address - Phone:206-251-5715
Mailing Address - Fax:
Practice Address - Street 1:30613 132ND CT SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-3275
Practice Address - Country:US
Practice Address - Phone:206-251-5715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional