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Individual

DR. ALIREZA K ANISSIPOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3726 BROADWAY, SUITE 201, EVERETT, WA 98201-3787
(425) 317-9119
Mailing address
1728 W MARINE VIEW DR, SUITE 110, EVERETT, WA 98201-2094
(425) 259-4041

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
OP60435741
WA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
OP60435741
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1033352968
WA
Enumeration date
04/07/2009
Last updated
01/16/2017
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