Provider Demographics
NPI:1992501985
Name:BAHZAD, VICTOR C
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:C
Last Name:BAHZAD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 PIONEER CT
Mailing Address - Street 2:
Mailing Address - City:EVERSON
Mailing Address - State:WA
Mailing Address - Zip Code:98247-8736
Mailing Address - Country:US
Mailing Address - Phone:360-924-5804
Mailing Address - Fax:
Practice Address - Street 1:4264 PACIFIC HWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9042
Practice Address - Country:US
Practice Address - Phone:360-393-0783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60878256225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist