Active NPI
Abdulla Shirzad, PA
- Physician Assistant
- Yakima, WA
National Provider Identifier
1235264607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10002016
- Practice address
- 12 S 8TH St
Yakima, WA 98901-3020 - Phone
- (509) 454-4143
- Fax
- (509) 454-3651
- NPI assigned
- Feb 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10002016 | WA | Primary |
Addresses
Primary practice location
12 S 8TH St
Yakima, WA 98901-3020
Mailing address
PO Box 2605
Yakima, WA 98907-2605
Phone (509) 454-4143
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8208670 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10002016 | WA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309996800000",
"number": "1235264607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2605",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989072605",
"telephone_number": "509-454-4143",
"fax_number": "509-454-3651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 S 8TH ST",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989013020",
"telephone_number": "509-454-4143",
"fax_number": "509-454-3651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRZAD",
"first_name": "ABDULLA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-23",
"last_updated": "2011-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10002016",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8208670",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.