Provider Demographics
NPI:1568076404
Name:HEYDARINIA, VAHID
Entity Type:Individual
Prefix:MR
First Name:VAHID
Middle Name:
Last Name:HEYDARINIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5622 S 237TH ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-3309
Mailing Address - Country:US
Mailing Address - Phone:206-290-0540
Mailing Address - Fax:
Practice Address - Street 1:5622 S 237TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-3309
Practice Address - Country:US
Practice Address - Phone:206-290-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA4262171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter