Individual provider Active NPI

Javad Abbas Sajan, M.D.,

  • Plastic and Reconstructive Surgery Physician
  • Seattle, WA
National Provider Identifier
1679717748
Registry record updated Sep 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
60430545 Issued in WA
Practice address
1455 NW Leary Way
Suite 449
Seattle, WA 98107-5124
Phone
(206) 209-0988
NPI assigned
Apr 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 60430545 WA
Plastic and Reconstructive Surgery Physician 2086S0122X 60430545 WA Primary

Addresses

Primary practice location

1455 NW Leary Way
Suite 449
Seattle, WA 98107-5124

Mailing address

1455 NW Leary Way Ste 449
Seattle, WA 98107-5124
Phone (206) 209-0988

Other identifiers 1

IdentifierTypeStateIssuer
2048314MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60430545WAMDOtolaryngology/Facial Plastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1679717748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 NW LEARY WAY STE 449",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075124",
            "telephone_number": "206-209-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 NW LEARY WAY",
            "address_2": "SUITE 449",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075124",
            "telephone_number": "206-209-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAJAN",
        "first_name": "JAVAD",
        "middle_name": "ABBAS",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-20",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "WA",
            "license": "60430545",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "60430545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2048314",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.