Provider Demographics
NPI:1891684445
Name:SIDDIQUA, MAHRUMA KHATOON (NURSE)
Entity type:Individual
Prefix:
First Name:MAHRUMA
Middle Name:KHATOON
Last Name:SIDDIQUA
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17446 NE 28TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052
Mailing Address - Country:US
Mailing Address - Phone:425-505-1477
Mailing Address - Fax:
Practice Address - Street 1:17446 NE 28TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6242
Practice Address - Country:US
Practice Address - Phone:425-505-1477
Practice Address - Fax:425-505-1477
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61575883163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health