Provider Demographics
NPI:1053896050
Name:SHEIKH, AJAZ BASHIR
Entity type:Individual
Prefix:
First Name:AJAZ
Middle Name:BASHIR
Last Name:SHEIKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 S 23RD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1602
Mailing Address - Country:US
Mailing Address - Phone:253-272-5127
Mailing Address - Fax:253-404-0506
Practice Address - Street 1:1135 16TH AVE NE
Practice Address - Street 2:SUITE 570
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4632
Practice Address - Country:US
Practice Address - Phone:425-454-4768
Practice Address - Fax:425-462-8021
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60994938367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty