Healthcare Provider Details

I. General information

NPI: 1235710427
Provider Name (Legal Business Name): SAEID MOJIRI INTERPRETER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 NE 12TH ST APT 25-18
RENTON WA
98059-4073
US

IV. Provider business mailing address

4455 NE 12TH ST APT 25-18
RENTON WA
98059-4073
US

V. Phone/Fax

Practice location:
  • Phone: 206-578-8537
  • Fax:
Mailing address:
  • Phone: 206-578-8537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License NumberMA3866
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: