Provider Demographics
NPI:1225216369
Name:KHORAMI, KEYANOOSH (ND)
Entity Type:Individual
Prefix:DR
First Name:KEYANOOSH
Middle Name:
Last Name:KHORAMI
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17530 132ND AVE NE
Mailing Address - Street 2:SUITE G
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8500
Mailing Address - Country:US
Mailing Address - Phone:425-483-1200
Mailing Address - Fax:
Practice Address - Street 1:17530 132ND AVE NE
Practice Address - Street 2:SUITE G
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-8500
Practice Address - Country:US
Practice Address - Phone:425-483-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001572175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath