Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | 0331 | WA |
NPI | 1841366945 |
---|---|
Provider Name | Amir H Salehi |
First Address | Bothell, WA 98011-3803 |
Second Address | Bothell, WA 98011-3803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |