Provider Demographics
NPI:1992026561
Name:BADREI, MAHYAR (DO)
Entity type:Individual
Prefix:DR
First Name:MAHYAR
Middle Name:
Last Name:BADREI
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 116TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17181 REDMOND WAY STE 300
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4441
Practice Address - Country:US
Practice Address - Phone:425-635-6430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4846208M00000X
261QP2300X
WAOP61156104207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care