Provider Demographics
NPI:1821010893
Name:SEAN LAGHAEIAN, DPM
Entity type:Organization
Organization Name:SEAN LAGHAEIAN, DPM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAGHAEIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:253-875-7375
Mailing Address - Street 1:9909 224TH ST E
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-7086
Mailing Address - Country:US
Mailing Address - Phone:253-875-7375
Mailing Address - Fax:253-875-7371
Practice Address - Street 1:9909 224TH ST E
Practice Address - Street 2:SUITE 120
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-7086
Practice Address - Country:US
Practice Address - Phone:253-875-7375
Practice Address - Fax:253-875-7371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000658213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8800025OtherINDIVIDUAL MEDICARE
WA1112978Medicaid
1184640575OtherINDIVIDUAL NPI
1821010893OtherGROUP NPI
WAP00144949OtherMEDICARE - RAILROAD
WAG8800023Medicare PIN
8800025OtherINDIVIDUAL MEDICARE