Individual
FADY R IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
602 E NOB HILL BLVD, YAKIMA, WA 98901-3534
(509) 248-3334
(509) 865-0757
Mailing address
PO BOX 190, TOPPENISH, WA 98948-0190
(509) 853-2395
(509) 865-0757
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OP61459797
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2213746
—
WA
Enumeration date
03/24/2022
Last updated
09/08/2025
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