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General NPI Number Information
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NPI Number | 1477516854
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Entity Type | Individual
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Provider Name | DR. YASMIN BADRUDIN KASSAM
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Gender | Female
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 11311 BRIDGEPORT WAY SW STE 100
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City | LAKEWOOD
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State | WA
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Zip | 98499-3096
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Country | US
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Telephone | 253-985-6490
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Fax |
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Provider Business Mailing Address
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Address Line | 11311 BRIDGEPORT WAY SW STE 100
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City | LAKEWOOD
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State | WA
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Zip | 98499-3096
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Country | US
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Telephone | 253-985-6490
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 072957
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 032080
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD60871380
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License Number State | WA
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