Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | OP60435741 | WA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | OP60435741 | WA |
NPI | 1033352968 |
---|---|
Provider Name | Dr. Alireza K Anissipour |
First Address | Everett, WA 98201-2094 |
Second Address | Everett, WA 98201-3787 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2009 |
Last Update Date | 16/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033352968 | (05) | WA |