Provider Demographics
NPI:1881731370
Name:ABDEL-RAHMAN, KHALED AHMED ESSAM (MD)
Entity type:Individual
Prefix:DR
First Name:KHALED
Middle Name:AHMED ESSAM
Last Name:ABDEL-RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9809 NE 30TH ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-1840
Mailing Address - Country:US
Mailing Address - Phone:253-833-6688
Mailing Address - Fax:561-282-3238
Practice Address - Street 1:202 N DIVISION ST
Practice Address - Street 2:SUITE 404
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-833-6688
Practice Address - Fax:253-833-5388
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00042646174400000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8358145Medicaid
WAH95786Medicare UPIN
WA8855235Medicare PIN