Healthcare Provider Details

I. General information

NPI: 1821706425
Provider Name (Legal Business Name): HUDA ALIEDANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2022
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10920 SE 208TH ST
KENT WA
98031-4009
US

IV. Provider business mailing address

5313 188TH ST SW # B-9
LYNNWOOD WA
98037-4577
US

V. Phone/Fax

Practice location:
  • Phone: 253-236-3999
  • Fax:
Mailing address:
  • Phone: 425-345-1762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License NumberDN61327087
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: