1295467421 NPI number — THILINI DANANJANEE WALGAMAGE M.D.

Table of content: THILINI DANANJANEE WALGAMAGE M.D. (NPI 1295467421)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295467421 NPI number — THILINI DANANJANEE WALGAMAGE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALGAMAGE
Provider First Name:
THILINI
Provider Middle Name:
DANANJANEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1295467421
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/13/2023
NPI Reactivation Date:
03/13/2023

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
315 M.L.K JR WAY (TACOMA GENERAL HOSPITAL)
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TACOMA GENERAL HOSPITAL
Provider Second Line Business Practice Location Address:
315 M.L.K JR WAY
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-403-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2022

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: 390200000X , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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