Basic Information
Provider Information
NPI: 1497986871
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALKINJ
FirstName: BASHAR
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 NE 87TH AVE
Address2:  
City: VANCOUVER
State: WA
PostalCode: 986644896
CountryCode: US
TelephoneNumber: 3608822778
FaxNumber:  
Practice Location
Address1: 700 NE 87TH AVE STE 250
Address2:  
City: VANCOUVER
State: WA
PostalCode: 98664
CountryCode: US
TelephoneNumber: 3608822778
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/03/2009
LastUpdateDate: 07/01/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XMD60830236WAN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200XMD60830236WAY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

ID Information
IDTypeStateIssuerDescription
210091405WA MEDICAID


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