Individual
DR. IBRAHIM A ABDULRAHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 S ZINTEL WAY, KADLEC CLINIC - KENNEWICK PRIMARY CARE, KENNEWICK, WA 99338
(509) 942-3125
(509) 783-2167
Mailing address
3900 S ZINTEL WAY, KENNEWICK, WA 99338
(509) 942-3627
(509) 942-2268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60105626
WA
208000000X
Pediatrics Physician
Primary
MD60105626
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0306281
L&I NUMBER WA STATE
WA
05
—
1801081948
—
WA
01
—
500625216
OREGON MEDICAID
OR
Enumeration date
09/12/2007
Last updated
09/16/2013
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