Basic Information
| Provider Information | |||||||||
| NPI: | 1932517745 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMIR | ||||||||
| FirstName: | SADAF | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MBBS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9720 S TACOMA WAY | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984994456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535033666 | ||||||||
| FaxNumber: | 2535031633 | ||||||||
| Practice Location | |||||||||
| Address1: | 9720 S TACOMA WAY | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984994456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535033666 | ||||||||
| FaxNumber: | 2535031633 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2014 | ||||||||
| LastUpdateDate: | 12/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CO60866689 | WA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 207RA0401X | ML61246551 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Addiction Medicine |
No ID Information.