Provider Demographics
NPI:1184162190
Name:MAZHAR, ASRA (DO)
Entity type:Individual
Prefix:DR
First Name:ASRA
Middle Name:
Last Name:MAZHAR
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16916 140TH AVE NE STE 300
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6957
Mailing Address - Country:US
Mailing Address - Phone:425-481-6363
Mailing Address - Fax:
Practice Address - Street 1:16916 140TH AVE NE STE 300
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6957
Practice Address - Country:US
Practice Address - Phone:425-481-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61060524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine