Provider Demographics
NPI:1265174734
Name:BIJAN SHEIKHIZADEH DPM INC PC
Entity type:Organization
Organization Name:BIJAN SHEIKHIZADEH DPM INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIKHIZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:360-533-7388
Mailing Address - Street 1:1220 BASICH BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1053
Mailing Address - Country:US
Mailing Address - Phone:360-533-7388
Mailing Address - Fax:360-533-2529
Practice Address - Street 1:1220 BASICH BLVD STE C
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1053
Practice Address - Country:US
Practice Address - Phone:360-533-7388
Practice Address - Fax:360-533-2529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty