Healthcare Provider Details

I. General information

NPI: 1467999698
Provider Name (Legal Business Name): DR. AMIT HABOOSHEH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-7115
US

IV. Provider business mailing address

1959 NE PACIFIC ST
SEATTLE WA
98195-7115
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-8571
  • Fax:
Mailing address:
  • Phone: 206-598-8571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: