Provider Demographics
NPI:1215712369
Name:SABOURI, PARASTOU
Entity type:Individual
Prefix:DR
First Name:PARASTOU
Middle Name:
Last Name:SABOURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2533 NW THURMAN ST APT C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2759
Mailing Address - Country:US
Mailing Address - Phone:971-200-9192
Mailing Address - Fax:
Practice Address - Street 1:17600 NE DELFEL RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-6540
Practice Address - Country:US
Practice Address - Phone:360-635-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61463839152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist