Provider Demographics
NPI:1326625393
Name:ENGEL, FRESHTA BAHER
Entity type:Individual
Prefix:
First Name:FRESHTA
Middle Name:BAHER
Last Name:ENGEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:FRESHTA
Other - Middle Name:BAHER
Other - Last Name:ENGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2908
Mailing Address - Country:US
Mailing Address - Phone:425-277-1311
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:26401 PACIFIC HWY S STE 101
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-9247
Practice Address - Country:US
Practice Address - Phone:206-870-3590
Practice Address - Fax:206-824-1670
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD61443524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program