Healthcare Provider Details

I. General information

NPI: 1033245865
Provider Name (Legal Business Name): AASHIYANA FARUK KOREISHI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 KLICKITAT WAY SW SUITE 205 PSIP
SEATTLE WA
98134
US

IV. Provider business mailing address

12501 E MARGINAL WAY S STE 200
TUKWILA WA
98168-5163
US

V. Phone/Fax

Practice location:
  • Phone: 206-622-7747
  • Fax: 206-467-1470
Mailing address:
  • Phone: 844-344-4209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number60085890
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberL-221244
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number246048
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: