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General NPI Number Information
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NPI Number | 1417367541
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Entity Type | Individual
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Provider Name | AMIR KAZEROUNINIA M.D. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 907 GEORGIANA ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-3911
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Country | US
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Telephone | 360-565-0999
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Fax | 360-565-0901
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Provider Business Mailing Address
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Address Line | 939 CAROLINE ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-3909
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Country | US
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Telephone | 360-565-0500
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP10049210
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | BP10049210
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD61309233
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License Number State | WA
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