Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD00031515 | WA |
NPI | 1245380468 |
---|---|
Provider Name | Dr. Assadullah Kazemi |
First Address | Seattle, WA 98108-2183 |
Second Address | Seattle, WA 98108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 16/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8203192 | (05) | WA |
G39086 | (02) | WA |