Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1033526579 |
---|---|
Provider Name | Ghazal Karimi Assil |
First Address | Seattle, WA 98104 |
Second Address | Seattle, WA 98104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2014 |
Last Update Date | 16/07/2014 |