Healthcare Provider Details

I. General information

NPI: 1093383887
Provider Name (Legal Business Name): ANISA A HAJI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2133 3RD AVE
SEATTLE WA
98121-2385
US

IV. Provider business mailing address

6711 S 239TH PL APT A103
KENT WA
98032-2600
US

V. Phone/Fax

Practice location:
  • Phone: 206-580-8494
  • Fax:
Mailing address:
  • Phone: 253-329-1994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: