Healthcare Provider Details

I. General information

NPI: 1013522580
Provider Name (Legal Business Name): HOLISTIC FAMILY CARE CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 M ST NE STE 105
AUBURN WA
98002-4503
US

IV. Provider business mailing address

721 M ST NE STE 105
AUBURN WA
98002-4503
US

V. Phone/Fax

Practice location:
  • Phone: 253-766-1161
  • Fax: 253-804-5655
Mailing address:
  • Phone: 253-766-1161
  • Fax: 253-804-5655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MUNA IBRAHIM OSMAN
Title or Position: ARNP
Credential: DNP FNP-BC
Phone: 253-766-1161