Healthcare Provider Details

I. General information

NPI: 1669854469
Provider Name (Legal Business Name): DR. ARMAN M ABEDI JONI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8609 EVERGREEN WAY
EVERETT WA
98208-2619
US

IV. Provider business mailing address

4111 194TH ST SW
LYNNWOOD WA
98036-4604
US

V. Phone/Fax

Practice location:
  • Phone: 425-789-3700
  • Fax: 425-789-3750
Mailing address:
  • Phone: 425-835-5204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE60567266
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: