Provider Demographics
NPI:1861620601
Name:ABDULLAH, ASIF (MD)
Entity type:Individual
Prefix:DR
First Name:ASIF
Middle Name:
Last Name:ABDULLAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 FAWCETT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-1900
Mailing Address - Country:US
Mailing Address - Phone:253-761-4200
Mailing Address - Fax:253-446-3973
Practice Address - Street 1:2502 S UNION AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1328
Practice Address - Country:US
Practice Address - Phone:253-841-4653
Practice Address - Fax:253-446-3973
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ453312085N0700X
TXP82062085R0202X
OH35.0981722085R0202X
CODR.00504782085R0202X
FLME1303392085R0202X
WAMD613520432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology