Provider Demographics
NPI:1285451245
Name:TADMORI, ASMAH (PA)
Entity type:Individual
Prefix:
First Name:ASMAH
Middle Name:
Last Name:TADMORI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 191ST ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4942
Mailing Address - Country:US
Mailing Address - Phone:206-307-9340
Mailing Address - Fax:
Practice Address - Street 1:23131 BOTHELL EVERETT HWY STE B
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9362
Practice Address - Country:US
Practice Address - Phone:425-483-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1226050363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant