Provider Demographics
NPI:1750658662
Name:ELHALABY, SALIM (NP)
Entity type:Individual
Prefix:
First Name:SALIM
Middle Name:
Last Name:ELHALABY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 WELCH RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 SE MARTIN LUTHER KING JR BLVD UNIT 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2595
Practice Address - Country:US
Practice Address - Phone:503-664-9451
Practice Address - Fax:503-386-3230
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-20
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202210765NP-PP363L00000X
WAAP61321680363L00000X
GARN227176363L00000X
CA95019867363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner