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Contact Information

TYANA SHABAZZ
2811 S 102ND ST STE 220
TUKWILA, WA98168-1869
 Phone: 408-863-1705
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse's Aide

376K00000X
 

Home Health Aide

374U00000X
Indicates primary specialty

NPI Profile & details for TYANA SHABAZZ · (Female)

NPI # 1952150807
Status Active
Credentials
Entity Individual
Enumeration date 05/14/2024
Last updated 09/06/2024 - More than a year ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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