Healthcare Provider Details

I. General information

NPI: 1780386334
Provider Name (Legal Business Name): OMEED FAGHIH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21601 76TH AVE W
EDMONDS WA
98026-7507
US

IV. Provider business mailing address

21601 76TH AVE W
EDMONDS WA
98026-7507
US

V. Phone/Fax

Practice location:
  • Phone: 425-640-4000
  • Fax:
Mailing address:
  • Phone: 425-802-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD.MD.70123439
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: