Healthcare Provider Details

I. General information

NPI: 1528972627
Provider Name (Legal Business Name): HADIZA MOHAMMED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 21ST AVE S APT 309
SEATTLE WA
98144-4575
US

IV. Provider business mailing address

1700 21ST AVE S APT 309
SEATTLE WA
98144-4575
US

V. Phone/Fax

Practice location:
  • Phone: 510-610-5287
  • Fax:
Mailing address:
  • Phone: 510-610-5287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.70052837
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: