Provider Demographics
NPI:1194307454
Name:BAIMANINEJAD, RAMIN (MD)
Entity type:Individual
Prefix:DR
First Name:RAMIN
Middle Name:
Last Name:BAIMANINEJAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4112 HARBOUR POINTE BLVD SW STE 100
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-5457
Mailing Address - Country:US
Mailing Address - Phone:425-347-6330
Mailing Address - Fax:
Practice Address - Street 1:4112 HARBOUR POINTE BLVD SW STE 100
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-5457
Practice Address - Country:US
Practice Address - Phone:425-347-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61467654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine