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NPI Code Detail

MEDICARE: HIBAQ A IBRAHIM RN

MEDICARE: HIBAQ A IBRAHIM RN
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
12083P0901XPublic Health & General Preventive Medicine PhysicianRN70019852WA

General Provider Information

NPI Number : 1376487058
Entity Type Code : Individual
Provider Name (Legal Business Name) : HIBAQ A IBRAHIM RN
Provider Business Mailing Address
First Line : 25742 104TH AVE SE
Second Line :
City : KENT
State : WA
Zip : 98030-7691
Country : US
Telephone Number : 206-477-6950
Fax Number :
Provider Business Practice Location Address
First Line : 25742 104TH AVE SE
Second Line :
City : KENT
State : WA
Zip : 98030-7691
Country : US
Telephone Number : 206-477-6950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “ HIBAQ A IBRAHIM RN” Practice Location

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