Doctor Name: | SEYED AHMAD HASSANTASH |
NPI Number: | 1174988513 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 60546447 |
Business Practice Address: | 227 247th Pl Ne Sammamish, WA - 980743484 |
Business Phone Number: | 5129822583 |
Business Fax Number: | |
Mailing Address: | 227 247th Pl Ne, SAMMAMISH |
State: | WA |
Postal Code: | 980743484 |
Phone Number: | 5129822583 |
Fax Number: | |
NPI Enumeration Date: | 12/30/2015 |
NPI Last Update Date: | 12/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 60546447 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |