Healthcare Provider Details

I. General information

NPI: 1275809139
Provider Name (Legal Business Name): RANA ROGHIEH BAHARLOO ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 E GREENLAKE WAY N STE 250
SEATTLE WA
98115
US

IV. Provider business mailing address

6900 E GREEN LAKE WAY N APT 253
SEATTLE WA
98115-6497
US

V. Phone/Fax

Practice location:
  • Phone: 206-706-0306
  • Fax:
Mailing address:
  • Phone: 818-429-4073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60266367
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: