Healthcare Provider Details

I. General information

NPI: 1184021818
Provider Name (Legal Business Name): FARNOOSH RAHMANI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST RM CC404 BOX356172
SEATTLE WA
98195-6172
US

IV. Provider business mailing address

11017 111TH AVE NE
KIRKLAND WA
98033-5002
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-4247
  • Fax:
Mailing address:
  • Phone: 206-441-7732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number61502922
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License NumberLR60478881
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: