Provider Demographics
NPI:1225112063
Name:AMADI, ARASH JIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:JIAN
Last Name:AMADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ARASJ
Other - Middle Name:
Other - Last Name:JIAN-AMADI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:206-543-6420
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-731-3225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039588207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1225112063Medicaid
WA180043069OtherRAIL ROAD MEDICARE
WA180043069OtherRAIL ROAD MEDICARE
WAH14936Medicare UPIN
WA8804333Medicare PIN