Individual provider · NPI-1

Bahram Badri

Family Medicine · Olympia, WA

NPI number1013399419
StatusActive
Last updated in NPPESJan 29, 2024

Details

NPI
1013399419
Entity type
Individual (NPI-1)
Name
Bahram Badri
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 22, 2015
Certification date
Jan 29, 2024
Last updated
Jan 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineMD61379551WAYes
207Q00000X Family Medicine68620WI

Practice location

700 Lilly Rd Ne
Olympia, WA 98506-5115

Phone 360-923-7000 · Fax 360-923-7089

Mailing address

700 Lilly Rd Ne
Olympia, WA 98506-5196

Phone 360-923-7000 · Fax 360-923-7089

Other practice locations

5001 Silver Hill Rd
Suitland, MD 20746-5215

Phone 240-532-5139

310 W Main St
Sparta, WI 54656

Phone 608-262-2132

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