Provider Demographics
NPI:1447281605
Name:SAFFARI, BAHMAN (MD)
Entity type:Individual
Prefix:
First Name:BAHMAN
Middle Name:
Last Name:SAFFARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 S I ST
Mailing Address - Street 2:STE 402
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5016
Mailing Address - Country:US
Mailing Address - Phone:253-426-4780
Mailing Address - Fax:253-426-4599
Practice Address - Street 1:1624 S I ST
Practice Address - Street 2:STE 402
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5016
Practice Address - Country:US
Practice Address - Phone:253-426-4780
Practice Address - Fax:253-426-4599
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71734207VX0201X
WAMD00046799207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0246028OtherL&I
WA8950422OtherCRIME VICTIMS
WA8464414Medicaid
WAP00716846OtherRAILROAD
WAG8879331OtherMEDICARE