Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD61105748 | WA |
NPI | 1033566336 |
---|---|
Provider Name | Miss Hebatalla Khaled Allam |
First Address | Richland, WA 99352-9532 |
Second Address | Portland, OR 97239-3098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2016 |
Last Update Date | 13/10/2021 |