Provider Demographics
NPI:1528853249
Name:BAROUTI, SHAHRIAR
Entity type:Individual
Prefix:
First Name:SHAHRIAR
Middle Name:
Last Name:BAROUTI
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 167TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-5143
Mailing Address - Country:US
Mailing Address - Phone:425-370-0883
Mailing Address - Fax:
Practice Address - Street 1:1258 167TH AVE SE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-5143
Practice Address - Country:US
Practice Address - Phone:425-370-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program