Provider Demographics
NPI:1952512329
Name:HAJIAN, HOOMAN (MD)
Entity Type:Individual
Prefix:
First Name:HOOMAN
Middle Name:
Last Name:HAJIAN
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 1:1111 PACIFIC AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4200
Mailing Address - Country:US
Mailing Address - Phone:425-257-1100
Mailing Address - Fax:425-257-1106
Practice Address - Street 1:1111 PACIFIC AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4200
Practice Address - Country:US
Practice Address - Phone:425-257-1100
Practice Address - Fax:425-257-1106
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA60150680207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8909711Medicare UPIN