Healthcare Provider Details

I. General information

NPI: 1730091299
Provider Name (Legal Business Name): MASITI A HAJI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 BROAD ST
BELLINGHAM WA
98225-8342
US

IV. Provider business mailing address

1545 NW MARKET ST APT 306
SEATTLE WA
98107-5255
US

V. Phone/Fax

Practice location:
  • Phone: 360-319-1524
  • Fax:
Mailing address:
  • Phone: 360-791-6606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCB61603586
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: