Provider Demographics
NPI:1386609279
Name:COUMAR, ANIL (MBBS, MA)
Entity type:Individual
Prefix:MR
First Name:ANIL
Middle Name:
Last Name:COUMAR
Suffix:
Gender:M
Credentials:MBBS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 NE 105TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-7530
Mailing Address - Country:US
Mailing Address - Phone:206-925-3158
Mailing Address - Fax:206-892-9705
Practice Address - Street 1:1225 NE 105TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7530
Practice Address - Country:US
Practice Address - Phone:206-925-3158
Practice Address - Fax:206-338-6379
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA02073LH00004449101YP2500X, 101YM0800X
WA020703 MH30003562101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional