Healthcare Provider Details

I. General information

NPI: 1396298352
Provider Name (Legal Business Name): MUHAMMAD MUBASHIR RAMZAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

425 N 190TH ST
SHORELINE WA
98133-3852
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3561
  • Fax: 206-744-8560
Mailing address:
  • Phone: 206-369-2325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberML60668499
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: