Basic Information
| Provider Information | |||||||||
| NPI: | 1952056541 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABABIO | ||||||||
| FirstName: | AMMA | ||||||||
| MiddleName: | SERWAA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1410 106TH PL SE | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982087701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143560924 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1016 TACOMA AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYSIDE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989442263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098371500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2022 | ||||||||
| LastUpdateDate: | 02/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 61242011 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.