Provider Demographics
NPI:1417463720
Name:AMADI AESTHETICS PLASTIC SURGERY PLLC
Entity Type:Organization
Organization Name:AMADI AESTHETICS PLASTIC SURGERY PLLC
Other - Org Name:AMADI AESTHETICS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:JIAN
Authorized Official - Last Name:AMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-216-4500
Mailing Address - Street 1:1503 2ND AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-3007
Mailing Address - Country:US
Mailing Address - Phone:206-216-4500
Mailing Address - Fax:206-216-4501
Practice Address - Street 1:1503 2ND AVE W
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3007
Practice Address - Country:US
Practice Address - Phone:206-216-4500
Practice Address - Fax:206-216-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000039588207WX0200X
WAPA10005371363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty