Healthcare Provider Details

I. General information

NPI: 1114771201
Provider Name (Legal Business Name): HALIMA DIRIYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5110 EVAN CT SE
AUBURN WA
98092-9537
US

IV. Provider business mailing address

5110 EVAN CT SE
AUBURN WA
98092-9537
US

V. Phone/Fax

Practice location:
  • Phone: 253-397-8265
  • Fax:
Mailing address:
  • Phone: 253-397-8265
  • Fax: 888-975-3307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number61096724
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: