Provider Demographics
NPI:1083341226
Name:UZMA A KHAN MD PLLC
Entity Type:Organization
Organization Name:UZMA A KHAN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:FACMPE
Authorized Official - Phone:503-791-5379
Mailing Address - Street 1:1405 SE 164TH AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9644
Mailing Address - Country:US
Mailing Address - Phone:503-791-5379
Mailing Address - Fax:
Practice Address - Street 1:1405 SE 164TH AVE
Practice Address - Street 2:STE 201
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9644
Practice Address - Country:US
Practice Address - Phone:503-791-5379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty