Healthcare Provider Details

I. General information

NPI: 1215891965
Provider Name (Legal Business Name): ANDIA ARY OSKOUI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 108TH AVE NE # 71
BELLEVUE WA
98004-4769
US

IV. Provider business mailing address

1021 204TH PL SW
LYNNWOOD WA
98036-8691
US

V. Phone/Fax

Practice location:
  • Phone: 425-443-4059
  • Fax:
Mailing address:
  • Phone: 425-443-4059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: