Provider Demographics
NPI:1033905468
Name:ABDALLAH, WHAILL M (BS)
Entity type:Individual
Prefix:MR
First Name:WHAILL
Middle Name:M
Last Name:ABDALLAH
Suffix:
Gender:
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2859
Mailing Address - Country:US
Mailing Address - Phone:971-710-2511
Mailing Address - Fax:503-974-1044
Practice Address - Street 1:2235 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2859
Practice Address - Country:US
Practice Address - Phone:971-710-2511
Practice Address - Fax:503-974-1044
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications