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General NPI Number Information
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NPI Number | 1134598949
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Entity Type | Individual
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Provider Name | RAMZY ASSAF
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Gender | Male
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Dates
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Enumeration Date | 09/22/2015
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 5000 ABBEY WAY SE
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City | LACEY
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State | WA
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Zip | 98503-3200
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Country | US
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Telephone | 360-438-4536
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1152
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City | SOUTH PASADENA
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State | CA
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Zip | 91031-1152
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Country | US
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Telephone |
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000014095
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA66507
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License Number State | CA
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