Provider Demographics
NPI:1215351911
Name:DASHTESTANI, SEDIGHEH (ARNP-CNM)
Entity type:Individual
Prefix:
First Name:SEDIGHEH
Middle Name:
Last Name:DASHTESTANI
Suffix:
Gender:F
Credentials:ARNP-CNM
Other - Prefix:
Other - First Name:SOPHIE
Other - Middle Name:
Other - Last Name:DASHTESTANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP-CNM
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:866-366-2983
Mailing Address - Fax:
Practice Address - Street 1:930 N BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1409
Practice Address - Country:US
Practice Address - Phone:425-317-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-15
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60244944367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife