Provider Demographics
NPI:1912776584
Name:WARSAME, MOHAMUD
Entity Type:Individual
Prefix:
First Name:MOHAMUD
Middle Name:
Last Name:WARSAME
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 1:27020 PACIFIC HWY S STE A
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-6951
Mailing Address - Country:US
Mailing Address - Phone:425-477-9310
Mailing Address - Fax:
Practice Address - Street 1:6329 S 212TH ST APT H103
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-2496
Practice Address - Country:US
Practice Address - Phone:425-477-9310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator