Provider Demographics
NPI:1699066530
Name:PAKZAD SEDIGH, HOSSEIN (MD)
Entity type:Individual
Prefix:
First Name:HOSSEIN
Middle Name:
Last Name:PAKZAD SEDIGH
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 1:3124 S 19TH ST
Mailing Address - Street 2:STE 340
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2433
Mailing Address - Country:US
Mailing Address - Phone:253-459-7000
Mailing Address - Fax:
Practice Address - Street 1:3124 S 19TH ST
Practice Address - Street 2:STE 340
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2433
Practice Address - Country:US
Practice Address - Phone:253-459-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ29818207XX0004X
WAMD60226675207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery