Provider Demographics
NPI:1912588294
Name:ABBASI, KHALDOUN M
Entity Type:Individual
Prefix:
First Name:KHALDOUN
Middle Name:M
Last Name:ABBASI
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 1:9096 BUTTERCUP ST SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-5579
Mailing Address - Country:US
Mailing Address - Phone:360-888-5280
Mailing Address - Fax:
Practice Address - Street 1:9096 BUTTERCUP ST SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-5579
Practice Address - Country:US
Practice Address - Phone:360-888-5280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-18
Last Update Date:2021-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter