Healthcare Provider Details

I. General information

NPI: 1477440980
Provider Name (Legal Business Name): UNKNOWN TEHMINA HASHIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 AUBURN WAY N STE B
AUBURN WA
98002-4117
US

IV. Provider business mailing address

955 POWELL AVE SW
RENTON WA
98057-2908
US

V. Phone/Fax

Practice location:
  • Phone: 253-351-3900
  • Fax:
Mailing address:
  • Phone: 630-414-4997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMDRE.ML.70115899
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: