Provider Demographics
NPI:1679380208
Name:MASOOD, MERAJUDDIN
Entity type:Individual
Prefix:
First Name:MERAJUDDIN
Middle Name:
Last Name:MASOOD
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 1:409 V PL SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-5883
Mailing Address - Country:US
Mailing Address - Phone:425-524-1852
Mailing Address - Fax:
Practice Address - Street 1:409 V PL SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5883
Practice Address - Country:US
Practice Address - Phone:425-524-1852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor