Provider Demographics
NPI:1932089430
Name:MAHAMOUD, FADUMA ABDIKANI (OT)
Entity type:Individual
Prefix:
First Name:FADUMA
Middle Name:ABDIKANI
Last Name:MAHAMOUD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16024 3RD PL S UNIT C
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1488
Mailing Address - Country:US
Mailing Address - Phone:253-202-7495
Mailing Address - Fax:
Practice Address - Street 1:16024 3RD PL S UNIT C
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-1488
Practice Address - Country:US
Practice Address - Phone:253-202-7495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT61673304225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics