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NPI Code Detail

MEDICARE: ROZITA JALILIANHASANPOUR MD

MEDICARE:   ROZITA  JALILIANHASANPOUR  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
22085R0202XDiagnostic Radiology PhysicianMDRE.ML.61295089WA

General Provider Information

NPI Number : 1134705619
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROZITA JALILIANHASANPOUR MD
Provider Business Mailing Address
First Line : 1959 NE PACIFIC STREET BOX 357115
Second Line :
City : SEATTLE
State : WA
Zip : 98195-7115
Country : US
Telephone Number : 206-598-2094
Fax Number :
Provider Business Practice Location Address
First Line : 1959 NE PACIFIC ST
Second Line :
City : SEATTLE
State : WA
Zip : 98195-1326
Country : US
Telephone Number : 206-598-2094
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2021
Last Update Date : 06/13/2022

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Directions to “ ROZITA JALILIANHASANPOUR MD” Practice Location

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