Basic Information
| Provider Information | |||||||||
| NPI: | 1932467933 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPECIALTY MEDICAL SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1130 N 185TH ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | SHORELINE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981334011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065421000 | ||||||||
| FaxNumber: | 2065425353 | ||||||||
| Practice Location | |||||||||
| Address1: | 1334 TERRY AVE | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981012747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065421000 | ||||||||
| FaxNumber: | 2065425353 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2012 | ||||||||
| LastUpdateDate: | 08/18/2022 | ||||||||
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| AuthorizedOfficialLastName: | ALHYRABA | ||||||||
| AuthorizedOfficialFirstName: | MOHAMMED | ||||||||
| AuthorizedOfficialMiddleName: | UMRAN | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9175312834 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 08/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RC0200X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.