Provider Demographics
NPI:1275809139
Name:BAHARLOO, RANA ROGHIEH (ND)
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:ROGHIEH
Last Name:BAHARLOO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 E GREEN LAKE WAY N APT 253
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6497
Mailing Address - Country:US
Mailing Address - Phone:818-429-4073
Mailing Address - Fax:
Practice Address - Street 1:6800 E GREENLAKE WAY N STE 250
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115
Practice Address - Country:US
Practice Address - Phone:206-706-0306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60266367175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath