Provider Demographics
NPI:1386106979
Name:BOUMAN ALI, AHLAM
Entity type:Individual
Prefix:
First Name:AHLAM
Middle Name:
Last Name:BOUMAN ALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10803 SE KENT KANGLEY RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7194
Mailing Address - Country:US
Mailing Address - Phone:206-816-3253
Mailing Address - Fax:
Practice Address - Street 1:10803 SE KENT KANGLEY RD
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7194
Practice Address - Country:US
Practice Address - Phone:206-816-3253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor