Healthcare Provider Details

I. General information

NPI: 1770547572
Provider Name (Legal Business Name): HASSAN Y. TEHRANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W 5TH AVE SUITE 1000
SPOKANE WA
99204-2966
US

IV. Provider business mailing address

PO BOX 3649
SPOKANE WA
99220-3649
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-2531
  • Fax: 509-755-6580
Mailing address:
  • Phone: 509-838-2531
  • Fax: 509-755-6580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME84288
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD60321869
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD60321869
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: