Provider Demographics
NPI:1053026765
Name:AL MUSAWI, LIWAA
Entity type:Individual
Prefix:
First Name:LIWAA
Middle Name:
Last Name:AL MUSAWI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13464 SW UTE ST
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-7325
Mailing Address - Country:US
Mailing Address - Phone:971-990-2057
Mailing Address - Fax:
Practice Address - Street 1:13464 SW UTE ST
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-7325
Practice Address - Country:US
Practice Address - Phone:971-990-2057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)