Provider Demographics
NPI:1326163650
Name:HASAN, MASUD SYED (DC)
Entity Type:Individual
Prefix:DR
First Name:MASUD
Middle Name:SYED
Last Name:HASAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13433 NE 20TH ST
Mailing Address - Street 2:STE. D
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2024
Mailing Address - Country:US
Mailing Address - Phone:425-747-7785
Mailing Address - Fax:425-747-7716
Practice Address - Street 1:13433 NE 20TH ST
Practice Address - Street 2:STE. D
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2024
Practice Address - Country:US
Practice Address - Phone:425-747-7785
Practice Address - Fax:425-747-7716
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU75267Medicare UPIN
WA8803287Medicare ID - Type Unspecified