Provider Demographics
NPI:1871454231
Name:EBRAHIM, ERZIK A
Entity type:Individual
Prefix:
First Name:ERZIK
Middle Name:A
Last Name:EBRAHIM
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 1:5811 RAINIER AVE S STE 111
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2705
Mailing Address - Country:US
Mailing Address - Phone:206-383-5539
Mailing Address - Fax:206-260-2741
Practice Address - Street 1:5811 RAINIER AVE S STE 111
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2705
Practice Address - Country:US
Practice Address - Phone:206-383-5539
Practice Address - Fax:206-260-2741
Is Sole Proprietor?:No
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61587671163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse