# ROOZBEH KHOSRAVI

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538545637
- **Authorized official:** ROOZBEH KHOSRAVI DMD, PHD (OWNER)
- **Authorized official phone:** (617) 466-9090

## Contact information

- **Practice address:** 3555 MCKINLEY AVE, TACOMA, WA 98404-2162
- **Practice address phone:** (617) 466-9090
- **Mailing address:** 5101 NE 55TH ST, 304, SEATTLE, WA 98105-2868
- **Mailing address phone:** (617) 466-9090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE60504324 | WA | Yes |

## Other

- **Enumeration date:** 07/31/2015
- **Last updated:** 07/31/2015