Healthcare Provider Details

I. General information

NPI: 1881222446
Provider Name (Legal Business Name): TAHMINA AKHTAR JAHAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EVA JAHAN M.D.

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 164TH STREET SE SUITE 100
MILL CREEK WA
98012
US

IV. Provider business mailing address

805 164TH STREET SE SUITE 100
MILL CREEK WA
98012
US

V. Phone/Fax

Practice location:
  • Phone: 425-354-4296
  • Fax: 425-332-3495
Mailing address:
  • Phone: 425-828-2257
  • Fax: 425-896-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD61392176
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: