Organization Active NPI

ABA Nduom MD PLLC

  • Psychiatry Physician
  • Redmond, WA
National Provider Identifier
1174479133
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ABA NDUOM MD PLLC
Practice address
16771 NE 80TH St Ste 108
Redmond, WA 98052-3959
Phone
(425) 414-8799
NPI assigned
Mar 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nana ABA Nduom, MDNPI 1386088029
Title
Physician
Phone
(425) 414-8799

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

16771 NE 80TH St Ste 108
Redmond, WA 98052-3959

Mailing address

16771 NE 80TH St Ste 108
Redmond, WA 98052-3959
Phone (425) 414-8799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260422003218 WA Part B Supplier - Clinic/Group Practice 7012484405 Receives reassigned benefits from 1 practitioner
Practice locations: Redmond, WA

National Provider Directory

National Provider Directory

Locations

16771 NE 80th St
Ste 108
Redmond, WA 98052
Phone (425) 414-8799

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773100800000",
    "number": "1174479133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16771 NE 80TH ST STE 108",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523959",
            "telephone_number": "425-414-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16771 NE 80TH ST STE 108",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523959",
            "telephone_number": "425-414-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA NDUOM MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-10",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A",
        "authorized_official_last_name": "NDUOM",
        "authorized_official_first_name": "NANA",
        "authorized_official_middle_name": "ABA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "425-414-8799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.