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Individual

DR. MEHRDAD FARAHMAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 E COLUMBIA AVE, COLVILLE, WA 99114-3354
(509) 684-3701
(509) 684-5817
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00036564
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0151118
L AND I
05
8234999
WA
01
8924170
L AND I CRIME VICTIMS
01
AB32999
MEDICARE GROUP
WA
Enumeration date
10/12/2005
Last updated
05/18/2021
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