Healthcare Provider Details

I. General information

NPI: 1992653158
Provider Name (Legal Business Name): SEPIDEH SOHRABI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2026
Last Update Date: 03/21/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 NE 139TH ST
VANCOUVER WA
98686-2742
US

IV. Provider business mailing address

22714 20TH DR SE APT G202
BOTHELL WA
98021-7248
US

V. Phone/Fax

Practice location:
  • Phone: 360-397-1985
  • Fax: 360-604-1604
Mailing address:
  • Phone: 425-273-8371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: