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Individual

SEYED AHMAD HASSANTASH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
227 247TH PL NE, SAMMAMISH, WA 98074-3484
(512) 982-2583
Mailing address
227 247TH PL NE, SAMMAMISH, WA 98074-3484
(512) 982-2583

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
60546447
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60546447
WA MEDICAL LICENSE NUMBER
WA
Enumeration date
12/30/2015
Last updated
12/30/2015
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