Provider Demographics
NPI:1861140584
Name:SULTANI, SHABIR AHMAD
Entity type:Individual
Prefix:
First Name:SHABIR AHMAD
Middle Name:
Last Name:SULTANI
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 1:124 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5874
Mailing Address - Country:US
Mailing Address - Phone:206-423-7309
Mailing Address - Fax:
Practice Address - Street 1:124 4TH AVE S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5874
Practice Address - Country:US
Practice Address - Phone:206-423-7309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor