Provider Demographics
NPI:1114440641
Name:JAFARINEJAD, KIAN JOHN (HIS)
Entity Type:Individual
Prefix:MR
First Name:KIAN
Middle Name:JOHN
Last Name:JAFARINEJAD
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16320 SE MILL PLAIN BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-8918
Mailing Address - Country:US
Mailing Address - Phone:360-256-1814
Mailing Address - Fax:360-882-7979
Practice Address - Street 1:16320 SE MILL PLAIN BLVD STE 103
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-8918
Practice Address - Country:US
Practice Address - Phone:360-256-1814
Practice Address - Fax:360-882-7979
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist