Provider Demographics
NPI:1518300318
Name:BAKHTIAR, BINAWAR (MSW, LSWAA)
Entity Type:Individual
Prefix:MS
First Name:BINAWAR
Middle Name:
Last Name:BAKHTIAR
Suffix:
Gender:F
Credentials:MSW, LSWAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14836 SE 16TH ST APT 12
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-5850
Mailing Address - Country:US
Mailing Address - Phone:425-691-9334
Mailing Address - Fax:
Practice Address - Street 1:15600 REDMOND WAY STE 303
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3862
Practice Address - Country:US
Practice Address - Phone:425-691-9334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC60290274104100000X, 1041C0700X
1041C0700X
WASA61159953104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical