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General NPI Number Information
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NPI Number | 1093155483
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Entity Type | Individual
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Provider Name | MUDASSAR RAEES AHMAD MB,BS
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Gender | Male
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1708 YAKIMA AVE STE 300
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City | TACOMA
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State | WA
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Zip | 98405-5309
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Country | US
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Telephone | 253-363-8700
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Fax | 253-272-0419
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Provider Business Mailing Address
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Address Line | 1708 YAKIMA AVE STE 300
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City | TACOMA
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State | WA
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Zip | 98405-5309
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Country | US
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Telephone | 253-363-8700
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Fax | 253-272-0419
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | MD61659187
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 75089
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD458440
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD61659187
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 76305
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License Number State | MN
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