Provider Demographics
NPI:1093912016
Name:SHARIFI, NAZANIN (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:NAZANIN
Middle Name:
Last Name:SHARIFI
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10180 SE SUNNYSIDE ROAD
Mailing Address - Street 2:NORTHWEST PERMANENTE PC, PHYSICIANS AND SURGEONS
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015
Mailing Address - Country:US
Mailing Address - Phone:503-571-2671
Mailing Address - Fax:
Practice Address - Street 1:10180 SE SUNNYSIDE ROAD
Practice Address - Street 2:NORTHWEST PERMANENTE PC, PHYSICIANS AND SURGEONS
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015
Practice Address - Country:US
Practice Address - Phone:503-571-2671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD29344207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine