Provider Demographics
NPI:1548832348
Name:DHIMBIL, ABDULKLADIR O
Entity type:Individual
Prefix:
First Name:ABDULKLADIR
Middle Name:O
Last Name:DHIMBIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32728 3RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-5647
Mailing Address - Country:US
Mailing Address - Phone:206-261-1173
Mailing Address - Fax:
Practice Address - Street 1:32728 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-5647
Practice Address - Country:US
Practice Address - Phone:206-261-1173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter