NPIMap

Individual provider Active NPI

Maliheh Razavi, PA-C

  • Medical Physician Assistant
  • Vancouver, WA
National Provider Identifier
1689977852
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
60256605 Issued in WA
Practice address
14508 NW 20TH Ave Ste 102
Vancouver, WA 98685-8006
Phone
(360) 852-9070
Fax
(360) 397-2503
NPI assigned
Dec 10, 2010
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 60256605 WA Primary

Addresses

Primary practice location

14508 NW 20TH Ave Ste 102
Vancouver, WA 98685-8006

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other practice location 1

4311 11th Ave NE Ste 200
Seattle, WA 98105-6367
Phone (360) 367-1410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130529000426 WA Practitioner - Physician Assistant 6406094655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

118 S Pkwy Ave
Battle Ground, WA 98604-9215
Phone (360) 342-8060

14508 NE 20TH Ave
Suite 102
Vancouver, WA 98686-6434
Phone (360) 852-9070

19005 SE 34TH St
BLDG 3
Vancouver, WA 98683-1450
Phone (360) 726-6720

6100 NE 4TH Plain Blvd
Vancouver, WA 98661-6830
Phone (360) 947-2550

7410 Delaware LN
Vancouver, WA 98664-1408
Phone (360) 566-4402

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
60256605WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Feb 20, 2013 Accepting new patients
Sea Mar Community Health Centers CurrentSince Feb 20, 2013 Accepting new patients
Sea-Mar Community Health Center Past Accepting new patients

Locations

14508 NE 20th Ave
Ste 102
Vancouver, WA 98686
Phone (360) 574-9730

7410 Delaware Ln
Vancouver, WA 98664
Phone (360) 566-4402

7410 Delaware Ln
Uppr
Vancouver, WA 98664
Phone (360) 566-4402

Interoperability endpoints

  • Direct secure messaging: mrazavi450762@direct.multicare.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1689977852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14508 NW 20TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986858006",
            "telephone_number": "360-852-9070",
            "fax_number": "360-397-2503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056367",
            "country_code": "US",
            "telephone_number": "360-367-1410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAZAVI",
        "first_name": "MALIHEH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-10",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "60256605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.