Healthcare Provider Details

I. General information

NPI: 1295208981
Provider Name (Legal Business Name): MISS SALMA ELTAHIR ABDELRAHMANABDALLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2019
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 STEWART ST STE 300
SEATTLE WA
98101-1257
US

IV. Provider business mailing address

1023 ROANOKE AVE
ROANOKE RAPIDS NC
27870-3701
US

V. Phone/Fax

Practice location:
  • Phone: 405-406-7514
  • Fax:
Mailing address:
  • Phone: 252-541-1416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberLABA.AB.70143608
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: