Ibrahim Ali Ibrahim, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

61151275 Issued in WA

Practice address

4702 Davis Ave S Apt Bb202
Renton, WA 98055-8239

Phone

(206) 697-8181

NPI assigned

Jul 27, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1255004180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 DAVIS AVE S APT BB202",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980558239",
            "telephone_number": "206-697-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 DAVIS AVE S APT BB202",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980558239",
            "telephone_number": "206-697-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "IBRAHIM",
        "middle_name": "ALI",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "61151275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Yi-Rong Hwang, DPT
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• Alexandra Iani, MSW, LSWAIC, SUDPT
• Emily M Iannazzi, MS
• Lyudmila Ianosel, PHARMD
• Nisma Ibrahim, MSN, FNP-C
• Ideal Option, PLLC
• Ideal Telemedicine Services, LLC
• Soraknit Ieng
• Kenneth Y Igbalode, MD

• Psychiatric/Mental Health Nurse Practitioner in Renton, WA
• Providers in Renton, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.