Individual
DR. IRFAN A ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3315 S 23RD ST, SUITE 200, TACOMA, WA 98405-1605
(253) 272-9994
(253) 572-0468
Mailing address
3315 S 23RD ST, SUITE 200, TACOMA, WA 98405-1605
(253) 272-9994
(253) 572-0468
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00032608
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04298824
ECFMG
WA
01
—
108359
LABOR & INDUSTRIES
WA
05
—
8194482
—
WA
01
—
MD00032608
STATE LICENSE
WA
Enumeration date
04/21/2006
Last updated
03/07/2023
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