Provider Demographics
NPI:1528176898
Name:RAFEH, ZAHER A (DO)
Entity type:Individual
Prefix:
First Name:ZAHER
Middle Name:A
Last Name:RAFEH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:
Practice Address - Street 1:413 LILLY RD NE
Practice Address - Street 2:PMG SW WA PSPH HOSPITALISTS
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5133
Practice Address - Country:US
Practice Address - Phone:360-493-4069
Practice Address - Fax:360-493-7778
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60015358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H60794Medicare UPIN
H60794Medicare UPIN
LA1419575Medicaid
110001764Medicare ID - Type Unspecified
120002521Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MS00125645Medicaid