Healthcare Provider Details

I. General information

NPI: 1023974680
Provider Name (Legal Business Name): FARANGIS KASYMOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 NE 185TH ST APT 2013
BOTHELL WA
98011-9338
US

IV. Provider business mailing address

12600 NE 185TH ST APT 2013
BOTHELL WA
98011-9338
US

V. Phone/Fax

Practice location:
  • Phone: 425-375-1570
  • Fax:
Mailing address:
  • Phone: 425-375-1570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: