Healthcare Provider Details

I. General information

NPI: 1245117977
Provider Name (Legal Business Name): NAZANIN BEHESHTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18311 BOTHELL EVERETT HWY STE 180&260
BOTHELL WA
98012-5233
US

IV. Provider business mailing address

18311 BOTHELL EVERETT HWY STE 180&260
BOTHELL WA
98012-5233
US

V. Phone/Fax

Practice location:
  • Phone: 206-250-9014
  • Fax:
Mailing address:
  • Phone: 206-250-9014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCB70035305
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: