Provider Demographics
NPI:1447455738
Name:BIDARI, AFSHIN (MD)
Entity type:Individual
Prefix:DR
First Name:AFSHIN
Middle Name:
Last Name:BIDARI
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 1:10722 NE 60TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7429
Mailing Address - Country:US
Mailing Address - Phone:425-260-5225
Mailing Address - Fax:425-242-5429
Practice Address - Street 1:2015 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3018
Practice Address - Country:US
Practice Address - Phone:425-260-5225
Practice Address - Fax:425-242-5429
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60018353207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1447455738OtherNPI
WAG8896823Medicare PIN