Provider Demographics
NPI:1992168561
Name:KAMAL, SAMA
Entity type:Individual
Prefix:
First Name:SAMA
Middle Name:
Last Name:KAMAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SAMAA
Other - Middle Name:
Other - Last Name:KAMAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 W 5TH AVE STE 200W
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 W 5TH AVE STE 200W
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4803
Practice Address - Country:US
Practice Address - Phone:509-744-3750
Practice Address - Fax:509-744-3969
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD60910623207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program