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General NPI Number Information
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NPI Number | 1689065476
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Entity Type | Organization
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Legal Business Name | OPTIMO ANESTHESIA PLLC
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Dates
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Enumeration Date | 02/15/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 1900 116TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98004-3052
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Country | US
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Telephone | 206-486-6664
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 332
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City | MERCER ISLAND
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State | WA
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Zip | 98040-0332
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Country | US
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Telephone | 206-486-6664
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAFFI CHEMSIAN
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Credential | M.D.
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Telephone | 206-486-6664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 60187972
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License Number State | WA
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