Healthcare Provider Details

I. General information

NPI: 1700247590
Provider Name (Legal Business Name): NAWAL ALKHAROUF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9951 MICKELBERRY RD NW STE 101
SILVERDALE WA
98383-8309
US

IV. Provider business mailing address

4425 HARBOR COUNTRY DR R-146
GIG HARBOR WA
98335
US

V. Phone/Fax

Practice location:
  • Phone: 360-692-9362
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberMD60521122
License Number StateWA

VIII. Authorized Official

Name: DR. NAWAL ALKHAROUF
Title or Position: PEDIATRICIAN
Credential: M.D.
Phone: 571-246-2875