Healthcare Provider Details

I. General information

NPI: 1285451245
Provider Name (Legal Business Name): ASMAH TADMORI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23131 BOTHELL EVERETT HWY STE B
BOTHELL WA
98021-9362
US

IV. Provider business mailing address

428 191ST ST SW
LYNNWOOD WA
98036-4942
US

V. Phone/Fax

Practice location:
  • Phone: 425-483-3335
  • Fax:
Mailing address:
  • Phone: 206-307-9340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1226050
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA19416
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: