Provider Demographics
NPI:1174012009
Name:ADEBAMIJI, ADAKU (MD)
Entity type:Individual
Prefix:DR
First Name:ADAKU
Middle Name:
Last Name:ADEBAMIJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADAKU
Other - Middle Name:
Other - Last Name:LUCIOUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14040 EASTRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-2865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-7652
Practice Address - Fax:206-987-2521
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ390200000X
WAMD611423262080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program