Provider Demographics
NPI:1427344118
Name:MEHRABIAN, PEZHMAN (MD)
Entity type:Individual
Prefix:DR
First Name:PEZHMAN
Middle Name:
Last Name:MEHRABIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 SENECA ST
Mailing Address - Street 2:VIRGINIA MASON MEDICAL CENTER, MS: H8-GME
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2742
Mailing Address - Country:US
Mailing Address - Phone:206-583-6079
Mailing Address - Fax:
Practice Address - Street 1:925 SENECA ST
Practice Address - Street 2:VIRGINIA MASON MEDICAL CENTER, MS: H8-GME
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2742
Practice Address - Country:US
Practice Address - Phone:206-583-6079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAFE60577961390200000X
IL036135936390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program