MEDICARE: RAMLA DEEQ PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61600091	WA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10034503	OR

General Provider Information

NPI Number	:	1831924208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMLA DEEQ PMHNP-BC

Provider Business Mailing Address
First Line	:	10206 51ST AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98178-2129
Country	:	US
Telephone Number	:	951-345-0589
Fax Number	:	458-201-6966

Provider Business Practice Location Address
First Line	:	1500 NE IRVING ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-2243
Country	:	US
Telephone Number	:	503-567-6503
Fax Number	:	458-201-6966

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

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	12/18/2025

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