Provider Demographics
NPI:1912875873
Name:GHOBADI GHADI KOLAI, VAZNA (RN)
Entity type:Individual
Prefix:
First Name:VAZNA
Middle Name:
Last Name:GHOBADI GHADI KOLAI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 SW 299TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3557
Mailing Address - Country:US
Mailing Address - Phone:206-715-7463
Mailing Address - Fax:
Practice Address - Street 1:633 SW 299TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-3557
Practice Address - Country:US
Practice Address - Phone:206-715-7463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61424216101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor