Individual
NO NAME GIVEN IFATUJJAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22530 MERIDIAN AVE S, BOTHELL, WA 98021-8313
(425) 428-8140
Mailing address
22530 MERIDIAN AVE S, BOTHELL, WA 98021-8313
(425) 428-8140
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/18/2025
Last updated
04/18/2025
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