Provider Demographics
NPI:1881656262
Name:NADERSHAHI, ARASH (MD)
Entity Type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:NADERSHAHI
Suffix:
Gender:M
Credentials:MD
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 3905
Mailing Address - Street 2:DEPT. 4204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-3905
Mailing Address - Country:US
Mailing Address - Phone:360-514-9060
Mailing Address - Fax:360-514-9041
Practice Address - Street 1:1035 116TH AVE NE
Practice Address - Street 2:HOSPITALISTS DEPT.
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4604
Practice Address - Country:US
Practice Address - Phone:425-688-5072
Practice Address - Fax:425-467-3310
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039785207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8292021Medicaid
WA0156132OtherL & I WORKERS COMP.
WA110230610OtherRAILROAD MEDICARE
WA7258NAOtherREGENCE BLUESHIELD RIDER
WA110230610OtherRAILROAD MEDICARE
WA0156132OtherL & I WORKERS COMP.