Provider Demographics
NPI:1073607032
Name:AFLATOONI, IRADJ GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:IRADJ
Middle Name:GEORGE
Last Name:AFLATOONI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1968
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-1968
Mailing Address - Country:US
Mailing Address - Phone:253-922-5623
Mailing Address - Fax:253-922-5009
Practice Address - Street 1:6511 NE 138TH PL
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4909
Practice Address - Country:US
Practice Address - Phone:425-898-4796
Practice Address - Fax:425-898-4796
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021483208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1045426Medicaid
WA1045426Medicaid
A14925Medicare UPIN