Healthcare Provider Details

I. General information

NPI: 1033287974
Provider Name (Legal Business Name): SENAIT Y ABRAHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 15TH AVE SW
SEATTLE WA
98106-2820
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-1703
US

V. Phone/Fax

Practice location:
  • Phone: 206-965-1000
  • Fax: 206-965-1001
Mailing address:
  • Phone: 206-764-3335
  • Fax: 206-764-0489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00041209
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: