Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 60430545 | WA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 60430545 | WA |
NPI | 1679717748 |
---|---|
Provider Name | Dr. Javad Abbas Sajan |
First Address | Seattle, WA 98107-5124 |
Second Address | Seattle, WA 98107-5124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2009 |
Last Update Date | 29/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2048314 | (05) | WA |