Provider Demographics
NPI:1982463592
Name:ABAKPORO, IBRAHIM ONYEWUCHI
Entity Type:Individual
Prefix:MR
First Name:IBRAHIM
Middle Name:ONYEWUCHI
Last Name:ABAKPORO
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 1:3503 116TH ST SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-5370
Mailing Address - Country:US
Mailing Address - Phone:206-819-8741
Mailing Address - Fax:
Practice Address - Street 1:1615 75TH ST SW STE 210
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-6293
Practice Address - Country:US
Practice Address - Phone:425-261-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00170835163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse