Healthcare Provider Details

I. General information

NPI: 1942881347
Provider Name (Legal Business Name): HOMA SHAARBAF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 140TH AVE NE BLDG C
BELLEVUE WA
98005-1892
US

IV. Provider business mailing address

1639 N WINROCK ST
LIBERTY LAKE WA
99019-9479
US

V. Phone/Fax

Practice location:
  • Phone: 509-991-9855
  • Fax:
Mailing address:
  • Phone: 509-919-8554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.MD.61681002
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: