Provider Demographics
NPI:1861913832
Name:GAANI, UBAH (NP)
Entity type:Individual
Prefix:
First Name:UBAH
Middle Name:
Last Name:GAANI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 S OTHELLO ST STE 105F
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-3892
Mailing Address - Country:US
Mailing Address - Phone:206-910-0667
Mailing Address - Fax:206-535-1039
Practice Address - Street 1:4219 S OTHELLO ST STE 105F
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3892
Practice Address - Country:US
Practice Address - Phone:206-910-0667
Practice Address - Fax:206-535-1039
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020605363LF0000X
WAAP61204954363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1083613806Medicaid