Provider Demographics
NPI:1275352510
Name:ABUMENJEL, BASHIR MAHMUD ANWAR (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:BASHIR
Middle Name:MAHMUD ANWAR
Last Name:ABUMENJEL
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 7TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5657
Mailing Address - Country:US
Mailing Address - Phone:360-742-1541
Mailing Address - Fax:206-717-8161
Practice Address - Street 1:733 7TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5657
Practice Address - Country:US
Practice Address - Phone:360-742-1541
Practice Address - Fax:206-717-8161
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61033298163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health