Provider Demographics
NPI:1043339252
Name:DANESHGARAN, FARIBA (OD)
Entity Type:Individual
Prefix:DR
First Name:FARIBA
Middle Name:
Last Name:DANESHGARAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LAKE BELLEVUE DR STE 208
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2454
Mailing Address - Country:US
Mailing Address - Phone:425-777-1089
Mailing Address - Fax:
Practice Address - Street 1:9 LAKE BELLEVUE DR STE 208
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2454
Practice Address - Country:US
Practice Address - Phone:425-777-1089
Practice Address - Fax:425-285-8029
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11815152W00000X
WA3523152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist