Healthcare Provider Details

I. General information

NPI: 1649105719
Provider Name (Legal Business Name): MR. MOHAMED ABDELGADIR AHMED I
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12322 HIGHWAY 99 STE 125
EVERETT WA
98204-8549
US

IV. Provider business mailing address

12322 HIGHWAY 99 STE 125
EVERETT WA
98204-8549
US

V. Phone/Fax

Practice location:
  • Phone: 425-903-4076
  • Fax: 425-903-4048
Mailing address:
  • Phone: 425-903-4076
  • Fax: 425-903-4048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: