Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP60793184 | WA |
NPI | 1003332974 |
---|---|
Provider Name | Zainab Ali Gaal-Weber |
First Address | Renton, WA 98057-4970 |
Second Address | Covington, WA 98042-5563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2017 |
Last Update Date | 09/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2088499 | (05) | WA |
G8971817 | MEDICARE (01) | WA |