1841275005 NPI number — MRS. SRILAKSHMI PARVATHANENI R.PH

Table of content: MRS. SRILAKSHMI PARVATHANENI R.PH (NPI 1841275005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841275005 NPI number — MRS. SRILAKSHMI PARVATHANENI R.PH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARVATHANENI
Provider First Name:
SRILAKSHMI
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.PH
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:
1841275005
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7631 212TH ST SW STE D100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMONDS
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98026-7565
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-977-4880
Provider Business Mailing Address Fax Number:
425-977-4881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
653 156TH AVE NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98007-4823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-641-9127
Provider Business Practice Location Address Fax Number:
425-641-9108
Provider Enumeration Date:
12/09/2005

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: 183500000X , with the licence number:  PH59695 , 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)





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