Provider Demographics
NPI:1538971403
Name:SILLAH, HADDY
Entity type:Individual
Prefix:
First Name:HADDY
Middle Name:
Last Name:SILLAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 156TH ST SW APT G310
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-8480
Mailing Address - Country:US
Mailing Address - Phone:612-703-7176
Mailing Address - Fax:
Practice Address - Street 1:3816 156TH ST SW APT G310
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-8480
Practice Address - Country:US
Practice Address - Phone:612-703-7176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60310478376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide