Healthcare Provider Details

I. General information

NPI: 1750296588
Provider Name (Legal Business Name): FAHAD HANNAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-6043
US

IV. Provider business mailing address

4609 UNION BAY PL NE APT 331
SEATTLE WA
98105-4045
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-1128
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: