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Individual

BABAK ROSHANAEI-MOGHADDAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2271 NE 51ST ST, SEATTLE, WA 98105-5713
(206) 519-9010
(206) 522-7815
Mailing address
2271 NE 51ST ST, SEATTLE, WA 98105-5713
(206) 519-9010
(206) 522-7815

Taxonomy

Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
60175566
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP1-0026069
INSTITUTIONAL PERMIT
Enumeration date
06/12/2007
Last updated
04/25/2024
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