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Individual

TAJU ALI AHMED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
12738 SE 173RD PL, RENTON, WA 98058-6034
(206) 409-8266
Mailing address
12738 SE 173RD PL, RENTON, WA 98058-6034
(206) 409-8266

Taxonomy

Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
MA2525
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA2525
DSHS AUTHORIZAION
WA
01
SA1904
DSHS AUTHORIZATIONS
WA
Enumeration date
09/18/2020
Last updated
09/18/2020
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