1316985856 NPI number — ALVIN NAYAN MD

Table of content: ALVIN NAYAN MD (NPI 1316985856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316985856 NPI number — ALVIN NAYAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAYAN
Provider First Name:
ALVIN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316985856
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 34935
Provider Second Line Business Mailing Address:
DEPT # 73
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98124-1935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-243-9675
Provider Business Mailing Address Fax Number:
206-242-5630

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13030 MILITARY RD S
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
TUKWILA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98168-3085
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-243-9675
Provider Business Practice Location Address Fax Number:
206-242-5630
Provider Enumeration Date:
06/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2083X0100X , with the licence number:  MD00039866 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)