=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821622887
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUHYL MOHAMMAD MOHEBI PA-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2020
-----------------------------------------------------
Last Update Date | 02/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 875 WESLEY ST STE 250
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98223-1668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-435-2233
-----------------------------------------------------
Fax | 360-435-3966
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 875 WESLEY ST STE 250
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98223-1668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-435-2233
-----------------------------------------------------
Fax | 360-435-3966
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 1226031
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA61619553
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------