Pezhman Ahmadi

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

PR61549434 Issued in WA

Practice address

13030 Military Rd S FL 2
Tukwila, WA 98168-3085

Phone

(206) 839-3600

NPI assigned

May 17, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: pezhman.ahmadidds.p3@direct.hpc.nextgenshare.com
• Direct secure messaging: pezhman.ahmadi.p1@direct.frederikstedhealthvi.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1104517564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 N 10TH PL APT 1323",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575467",
            "telephone_number": "831-710-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13030 MILITARY RD S FL 2",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981683085",
            "telephone_number": "206-839-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 Strand St",
            "address_purpose": "LOCATION",
            "city": "Frederiksted",
            "state": "VI",
            "postal_code": "008403533",
            "country_code": "US",
            "telephone_number": "340-772-0260 x2106",
            "fax_number": "866-373-9926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMADI",
        "first_name": "PEZHMAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-17",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "PR61549434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgette Agpaoa Ryder, , EDD, LMHC
• Cristian Alejandro Aguilar Andrade, PSS
• Devyna Marie Aguon, MSW, LICSW
• Erin Ahearn
• Amelia Ahlen
• Aide Assisted Living LLC
• Malinda N Aitken
• Robinson Akaka
• Cenora Kimberly Akhidenor, RC
• Ryan Daniel Akin, BS, RC

• All providers in Tukwila, WA
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.