Provider Demographics
NPI:1225055023
Name:CHOWDHURY, ARIF A (MD)
Entity Type:Individual
Prefix:MR
First Name:ARIF
Middle Name:A
Last Name:CHOWDHURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34503 9TH AVE S STE 230
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8726
Mailing Address - Country:US
Mailing Address - Phone:253-838-3103
Mailing Address - Fax:360-782-3115
Practice Address - Street 1:34503 9TH AVE S STE 230
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8726
Practice Address - Country:US
Practice Address - Phone:253-838-3103
Practice Address - Fax:360-782-3115
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT97335689-12052084N0400X
IDM-122612084N0400X
WAMD605291892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2068052Medicaid