Individual
PEGAH REZVANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8012 15TH AVE NW, SEATTLE, WA 98117-3601
(206) 708-1212
Mailing address
23828 CARTER RD # B, BOTHELL, WA 98021-9408
(805) 312-5719
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
70113885
WA
225700000X
Massage Therapist
61206118
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
02/01/2022
Last updated
05/13/2026
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