Provider Demographics
NPI:1912505553
Name:GEWIDA, HANI HENRY
Entity Type:Individual
Prefix:
First Name:HANI
Middle Name:HENRY
Last Name:GEWIDA
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 1:2026 124TH ST SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6610
Mailing Address - Country:US
Mailing Address - Phone:425-943-1297
Mailing Address - Fax:
Practice Address - Street 1:2026 124TH ST SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6610
Practice Address - Country:US
Practice Address - Phone:425-943-1297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter