Provider Demographics
NPI:1215763149
Name:SHEMSHAKI, KAMBIZ
Entity type:Individual
Prefix:
First Name:KAMBIZ
Middle Name:
Last Name:SHEMSHAKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 88TH PL NE
Mailing Address - Street 2:
Mailing Address - City:CLYDE HILL
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2463
Mailing Address - Country:US
Mailing Address - Phone:206-883-4939
Mailing Address - Fax:
Practice Address - Street 1:2327 88TH PL NE
Practice Address - Street 2:
Practice Address - City:CLYDE HILL
Practice Address - State:WA
Practice Address - Zip Code:98004-2463
Practice Address - Country:US
Practice Address - Phone:206-883-4939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program