MEDICARE: MR. TAMAM ABUBAKAR GISHO RN61310581

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
1	163W00000X	Registered Nurse	RN61310581	WA

General Provider Information

NPI Number	:	1457295412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TAMAM ABUBAKAR GISHO RN61310581

Provider Business Mailing Address
First Line	:	25420 117TH PL SE
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98030-6531
Country	:	US
Telephone Number	:	206-353-4102
Fax Number	:

Provider Business Practice Location Address
First Line	:	25420 117TH PL SE
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98030-6531
Country	:	US
Telephone Number	:	206-353-4102
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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Directions to “ MR. TAMAM ABUBAKAR GISHO RN61310581” Practice Location

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