Basic Information
Provider Information
NPI: 1982847935
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOTAGHI
FirstName: ARASH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 560 GAGE BLVD
Address2: SUITE 203
City: RICHLAND
State: WA
PostalCode: 99352
CountryCode: US
TelephoneNumber: 5099423627
FaxNumber: 5099422268
Practice Location
Address1: 875 SWIFT BLVD
Address2:  
City: RICHLAND
State: WA
PostalCode: 993523592
CountryCode: US
TelephoneNumber: 5099461654
FaxNumber: 5099435652
Other Information
ProviderEnumerationDate: 04/07/2009
LastUpdateDate: 06/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XOP60503122WAN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900XOP60503122WAY Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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