Healthcare Provider Details

I. General information

NPI: 1669512315
Provider Name (Legal Business Name): MARMAR MAZHARI WRIGHT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARMAR M MAZHARI DC

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 01/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1299 156TH AVE NE STE 123
BELLEVUE WA
98007-7562
US

IV. Provider business mailing address

4479 249TH TER SE
ISSAQUAH WA
98029-5811
US

V. Phone/Fax

Practice location:
  • Phone: 425-641-8481
  • Fax: 425-641-0880
Mailing address:
  • Phone: 425-677-7227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00034512
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: