Provider Demographics
NPI:1841705886
Name:SALAAM HEALTH PLLC
Entity type:Organization
Organization Name:SALAAM HEALTH PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMD
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TACHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-269-8871
Mailing Address - Street 1:4219 S OTHELLO ST STE 105-F
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-3892
Mailing Address - Country:US
Mailing Address - Phone:253-269-8871
Mailing Address - Fax:206-769-5543
Practice Address - Street 1:4219 S OTHELLO ST STE 105-F
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3892
Practice Address - Country:US
Practice Address - Phone:253-269-8871
Practice Address - Fax:206-769-5543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175824OtherPK