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General NPI Number Information
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NPI Number | 1366907321
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Entity Type | Individual
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Provider Name | SEPIDEH POURPIRALI SABET OD
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Gender | Female
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 1815 MAIN ST STE 101
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City | FERNDALE
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State | WA
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Zip | 98248-9454
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Country | US
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Telephone | 360-746-8890
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Fax | 360-393-4004
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Provider Business Mailing Address
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Address Line | 3820 DEL BONITA WAY
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City | BELLINGHAM
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State | WA
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Zip | 98226-8858
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Country | US
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Telephone | 360-296-1283
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD60963237
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License Number State | WA
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