Provider Demographics
NPI:1316124134
Name:IRAJ AFLATOONI MD PS
Entity type:Organization
Organization Name:IRAJ AFLATOONI MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:AFLATOONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-542-1517
Mailing Address - Street 1:PO BOX 1968
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-1968
Mailing Address - Country:US
Mailing Address - Phone:253-922-5623
Mailing Address - Fax:253-922-5009
Practice Address - Street 1:6511 NE 138TH PL
Practice Address - Street 2:SUITE 217
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4909
Practice Address - Country:US
Practice Address - Phone:425-898-4796
Practice Address - Fax:425-898-4796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021483208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8802070Medicare PIN
A14925Medicare UPIN