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NPI Code Detail

MEDICARE: SOURA ALAA MUSTAPHA ARNP

MEDICARE: SOURA ALAA MUSTAPHA ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN61057597WA
2363L00000XNurse PractitionerAP61592937WA

General Provider Information

NPI Number : 1487268009
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOURA ALAA MUSTAPHA ARNP
Provider Business Mailing Address
First Line : 955 POWELL AVE SW
Second Line :
City : RENTON
State : WA
Zip : 98057-2908
Country : US
Telephone Number : 425-277-1311
Fax Number : 425-277-1566
Provider Business Practice Location Address
First Line : 16200 116TH AVE SE
Second Line :
City : RENTON
State : WA
Zip : 98058-5200
Country : US
Telephone Number : 425-400-1899
Fax Number : 425-663-8000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2020
Last Update Date : 01/23/2025

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Directions to “ SOURA ALAA MUSTAPHA ARNP” Practice Location

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