Provider Demographics
NPI:1366417982
Name:VAIMAN, IRINE L (MD)
Entity type:Individual
Prefix:
First Name:IRINE
Middle Name:L
Last Name:VAIMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 116TH AVE NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3097
Mailing Address - Country:US
Mailing Address - Phone:425-453-6838
Mailing Address - Fax:425-456-0106
Practice Address - Street 1:2007 152ND AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5521
Practice Address - Country:US
Practice Address - Phone:425-440-7777
Practice Address - Fax:425-440-7771
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00034126207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8203457Medicaid
WAAB02702Medicare ID - Type Unspecified
WAG38361Medicare UPIN