Provider Demographics
NPI:1447711544
Name:AHMADIAN, ASHKAN JONATHAN (MD)
Entity type:Individual
Prefix:
First Name:ASHKAN
Middle Name:JONATHAN
Last Name:AHMADIAN
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:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC STREET RADIOLOGY DEPARTMENT RR 210
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-1019
Practice Address - Country:US
Practice Address - Phone:206-598-6483
Practice Address - Fax:206-543-6317
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML.610567012085R0202X
WAMD614340892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology