Provider Demographics
NPI:1932726049
Name:AL SAEDI, USAMA
Entity Type:Individual
Prefix:
First Name:USAMA
Middle Name:
Last Name:AL SAEDI
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 1:1421 NW 85TH ST # 111
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4298
Mailing Address - Country:US
Mailing Address - Phone:206-789-0111
Mailing Address - Fax:
Practice Address - Street 1:1421 NW 85TH ST APT 110
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-4298
Practice Address - Country:US
Practice Address - Phone:206-789-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
D160753339126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant