Healthcare Provider Details

I. General information

NPI: 1447281605
Provider Name (Legal Business Name): BAHMAN SAFFARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 S I ST STE 402
TACOMA WA
98405-5016
US

IV. Provider business mailing address

1624 S I ST STE 402
TACOMA WA
98405-5016
US

V. Phone/Fax

Practice location:
  • Phone: 253-426-4780
  • Fax: 253-426-4599
Mailing address:
  • Phone: 253-426-4780
  • Fax: 253-426-4599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberA71734
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberMD00046799
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: