Healthcare Provider Details

I. General information

NPI: 1275865651
Provider Name (Legal Business Name): FAISA ABUKAR FAROLE LICENSE MIDWIFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2319 SW 320TH ST
FEDERAL WAY WA
98023-2514
US

IV. Provider business mailing address

2740 SW 342ND ST
FEDERAL WAY WA
98023-7609
US

V. Phone/Fax

Practice location:
  • Phone: 206-683-8167
  • Fax: 206-420-0366
Mailing address:
  • Phone: 206-683-8167
  • Fax: 425-207-3025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number7408917
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number60623982
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: