Individual
MR. MUSTAPHA I HYDARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
615 W TITUS ST, KENT, WA 98032-5749
(253) 670-4234
(253) 631-1375
Mailing address
13216 SE 263RD PL, KENT, WA 98042-3548
(253) 347-2665
(253) 631-1375
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60125636
WA
Other
Enumeration date
11/23/2009
Last updated
05/15/2013
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