Provider Demographics
NPI:1174274591
Name:MAHDI, ABDIRAHMAN M
Entity type:Individual
Prefix:
First Name:ABDIRAHMAN
Middle Name:M
Last Name:MAHDI
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 1:20957 37TH PL S APT B201
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6892
Mailing Address - Country:US
Mailing Address - Phone:206-802-5760
Mailing Address - Fax:206-222-0084
Practice Address - Street 1:14225 TUKWILA INTERNATIONAL BLVD STE 135
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4114
Practice Address - Country:US
Practice Address - Phone:206-802-5760
Practice Address - Fax:206-222-0084
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
342000000X
WA171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
No342000000XTransportation ServicesTransportation Network Company