Provider Demographics
NPI:1760517726
Name:KHAN, AAMER A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AAMER
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:WA
Mailing Address - Zip Code:98244
Mailing Address - Country:US
Mailing Address - Phone:360-966-2106
Mailing Address - Fax:360-966-2304
Practice Address - Street 1:6760 MISSION RD
Practice Address - Street 2:
Practice Address - City:EVERSON
Practice Address - State:WA
Practice Address - Zip Code:98247
Practice Address - Country:US
Practice Address - Phone:360-966-2106
Practice Address - Fax:360-966-2304
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AZ4194103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health