Provider Demographics
NPI:1922350024
Name:YASHRUTI, SALAH HADI (MD)
Entity Type:Individual
Prefix:DR
First Name:SALAH
Middle Name:HADI
Last Name:YASHRUTI
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 1:20911 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-2909
Mailing Address - Country:US
Mailing Address - Phone:206-347-6059
Mailing Address - Fax:
Practice Address - Street 1:1970 HARVARD AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-4250
Practice Address - Country:US
Practice Address - Phone:206-347-6059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00009086174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist