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NPI Code Detail

MEDICARE: REZA HOSSEINI GHOMI M.D., MSE

MEDICARE: REZA HOSSEINI GHOMI M.D., MSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianMD60664815WA

General Provider Information

NPI Number : 1659791770
Entity Type Code : Individual
Provider Name (Legal Business Name) : REZA HOSSEINI GHOMI M.D., MSE
Provider Business Mailing Address
First Line : 1959 NE PACIFIC ST
Second Line :
City : SEATTLE
State : WA
Zip : 98195-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1601 LEWIS AVE STE 102
Second Line :
City : BILLINGS
State : MT
Zip : 59102-4182
Country : US
Telephone Number : 406-272-6453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2014
Last Update Date : 01/21/2025

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