Healthcare Provider Details

I. General information

NPI: 1932999364
Provider Name (Legal Business Name): ASMAA TAHLIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 18TH AVE S
SEATTLE WA
98144-4317
US

IV. Provider business mailing address

325 W GOWE ST
KENT WA
98032-5892
US

V. Phone/Fax

Practice location:
  • Phone: 206-731-7210
  • Fax:
Mailing address:
  • Phone: 253-833-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN61597690
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: