Individual
DR. BASHAR ELALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00040370
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153276
WA STATE DL&I #
WA
05
—
8287864
—
WA
Enumeration date
12/06/2006
Last updated
01/11/2021
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