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NPI Code Detail

MEDICARE: SAMUEL SISAY HAILU MD

MEDICARE: SAMUEL SISAY HAILU MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramWA

General Provider Information

NPI Number : 1326994617
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL SISAY HAILU MD
Provider Business Mailing Address
First Line : 4800 SAND POINT WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98105-3901
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4800 SAND POINT WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98105-3901
Country : US
Telephone Number : 206-987-2134
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “ SAMUEL SISAY HAILU MD” Practice Location

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