Basic Information
Provider Information
NPI: 1174186837
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIRJANDIAN
FirstName: ZEINAB
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13626 179TH AVE NE
Address2:  
City: REDMOND
State: WA
PostalCode: 980522150
CountryCode: US
TelephoneNumber: 4252746077
FaxNumber:  
Practice Location
Address1: CARILION ROANOKE MEMORIAL HOSPITAL, 1906 BELLEVIEW AVE
Address2:  
City: ROANOKE
State: VA
PostalCode: 98052
CountryCode: US
TelephoneNumber: 5409817000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/18/2019
LastUpdateDate: 04/18/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000XSTUDENT Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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