Provider Demographics
NPI:1174413793
Name:SHEIMO, KASSIM IBRAHIM
Entity type:Individual
Prefix:
First Name:KASSIM
Middle Name:IBRAHIM
Last Name:SHEIMO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8816 60TH DR NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-2812
Mailing Address - Country:US
Mailing Address - Phone:425-565-1906
Mailing Address - Fax:360-386-8636
Practice Address - Street 1:8816 60TH DR NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-2812
Practice Address - Country:US
Practice Address - Phone:425-565-1906
Practice Address - Fax:360-386-8636
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60447699163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management