Healthcare Provider Details

I. General information

NPI: 1083452114
Provider Name (Legal Business Name): DR. BASMA MOHAMED AHMED SALEH GHONEIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

15203 8TH AVE S
BURIEN WA
98148-1114
US

IV. Provider business mailing address

12202 28TH AVE S APT M5
BURIEN WA
98168-2406
US

V. Phone/Fax

Practice location:
  • Phone: 206-679-0782
  • Fax: 206-420-0366
Mailing address:
  • Phone: 347-306-6570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: