Healthcare Provider Details

I. General information

NPI: 1265391346
Provider Name (Legal Business Name): BEHROUZ RAHIMI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE # #359608
SEATTLE WA
98104-2499
US

IV. Provider business mailing address

4906 25TH AVE NE APT 731E
SEATTLE WA
98105-5077
US

V. Phone/Fax

Practice location:
  • Phone: 206-685-1780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0108X
TaxonomyUveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
License NumberMDTR.TR.70089024
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: