Provider Demographics
NPI:1558394171
Name:AAF, NOOR A (PA-C)
Entity Type:Individual
Prefix:
First Name:NOOR
Middle Name:A
Last Name:AAF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 9TH AVE
Mailing Address - Street 2:BOX 359745
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2420
Mailing Address - Country:US
Mailing Address - Phone:206-744-3576
Mailing Address - Fax:206-744-4409
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-3576
Practice Address - Fax:206-744-4409
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10003380363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8355299Medicaid
WA15997UOtherREGENCE BLUE SHIELD PIN
WA0207299OtherL&I PIN
WA8859357Medicare PIN
WA15997UOtherREGENCE BLUE SHIELD PIN