Provider Demographics
NPI:1548476153
Name:ABOU OUF, HANAA ALI (MD)
Entity type:Individual
Prefix:
First Name:HANAA
Middle Name:ALI
Last Name:ABOU OUF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 S J ST
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4930
Mailing Address - Country:US
Mailing Address - Phone:253-274-7503
Mailing Address - Fax:253-274-7993
Practice Address - Street 1:1608 S J ST
Practice Address - Street 2:FLOOR 2
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4930
Practice Address - Country:US
Practice Address - Phone:253-274-7503
Practice Address - Fax:253-274-7993
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088035208000000X
IAMD-38213208000000X
WAMD60581818208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8948611Medicare PIN