Provider Demographics
NPI:1861680175
Name:SIMAS CLINIC INC
Entity Type:Organization
Organization Name:SIMAS CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFII-MALEK
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:425-398-2700
Mailing Address - Street 1:13317 NE 175TH ST STE N
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-3517
Mailing Address - Country:US
Mailing Address - Phone:425-398-2700
Mailing Address - Fax:425-398-2770
Practice Address - Street 1:13317 NE 175TH ST STE N
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-3517
Practice Address - Country:US
Practice Address - Phone:425-398-2700
Practice Address - Fax:425-398-2770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003216163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP73544Medicare UPIN
WA8869907Medicare PIN
WADP4848Medicare PIN