Basic Information
Provider Information
NPI: 1548476153
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABOU OUF
FirstName: HANAA
MiddleName: ALI
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1608 S J ST
Address2: FLOOR 2
City: TACOMA
State: WA
PostalCode: 984054930
CountryCode: US
TelephoneNumber: 2532747503
FaxNumber: 2532747993
Practice Location
Address1: 1608 S J ST
Address2: FLOOR 2
City: TACOMA
State: WA
PostalCode: 984054930
CountryCode: US
TelephoneNumber: 2532747503
FaxNumber: 2532747993
Other Information
ProviderEnumerationDate: 05/14/2007
LastUpdateDate: 05/05/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X4301088035MIN Allopathic & Osteopathic PhysiciansPediatrics 
208000000XMD-38213IAN Allopathic & Osteopathic PhysiciansPediatrics 
208000000XMD60581818WAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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