Healthcare Provider Details

I. General information

NPI: 1619993995
Provider Name (Legal Business Name): FARIDEH ESKANDARI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 08/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12303 NE 130TH LN SUITE 405
KIRKLAND WA
98034-3099
US

IV. Provider business mailing address

12303 NE 130TH LN SUITE 405
KIRKLAND WA
98034-3099
US

V. Phone/Fax

Practice location:
  • Phone: 425-242-5412
  • Fax: 425-242-5429
Mailing address:
  • Phone: 425-242-5412
  • Fax: 425-242-5429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD 00048717
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: