Jalali, Seyed Abdol Reza

Jalali, Seyed Abdol Reza is an individual health care provider with primary practice located at 2910 S Meridian Ste 350 , Puyallup WA 98373-1585. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Jalali, Seyed Abdol Reza can be contacted via phone (253) 445-5750.

Contact Information

Primary practice address
2910 S Meridian Ste 350 Puyallup WA 98373-1585
Phone: (253) 445-5750
Fax: (253) 426-4142
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D0060715 Maryland
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD60663353 Washington

Profile Details

NPI number 1043219819
LBN Legal business name Jalali, Seyed Abdol Reza
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Dec 4th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043219819 NPPES
Delaware MEDICAID 1000032342
Delaware MEDICAID 2061190
Delaware MEDICAID 404228000

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