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General NPI Number Information
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NPI Number | 1720875040
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Entity Type | Organization
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Legal Business Name | WHAILL ENTERPRISE LLC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 3160 NE 156TH AVE
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City | PORTLAND
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State | OR
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Zip | 97230-5166
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Country | US
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Telephone | 971-440-8289
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Fax |
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Provider Business Mailing Address
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Address Line | 7050 W VILLA LINDO DR
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City | PEORIA
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State | AZ
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Zip | 85383-3380
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Country | US
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Telephone | 602-475-4826
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. WHAILL MUTAWI ABDALLAH I
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Credential | MBE
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Telephone | 602-475-4826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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