Healthcare Provider Details

I. General information

NPI: 1417506312
Provider Name (Legal Business Name): HADDY MBYE-SAHO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HADDY MBYE ARNP

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 REPUBLICAN ST FL 2
SEATTLE WA
98109-4725
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145-5095
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax:
Mailing address:
  • Phone: 206-520-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61221728
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN275551
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: