Provider Demographics
NPI:1114117330
Name:TALEGHANI, MASOUD SEYED (MD)
Entity Type:Individual
Prefix:
First Name:MASOUD
Middle Name:SEYED
Last Name:TALEGHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12036 NE 73RD ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8115
Mailing Address - Country:US
Mailing Address - Phone:617-842-1650
Mailing Address - Fax:
Practice Address - Street 1:600 STEWART ST STE 300&400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1230
Practice Address - Country:US
Practice Address - Phone:844-403-4325
Practice Address - Fax:424-625-0010
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60076495207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine