1437289147 NPI number — JIGISH S. PATEL M.D.

Table of content: LILLY GARIBAY (NPI 1073207460)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437289147 NPI number — JIGISH S. PATEL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
JIGISH
Provider Middle Name:
S.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PATEL
Provider Other First Name:
JIGISHBHAI
Provider Other Middle Name:
S
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1437289147
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19020 33RD AVE W
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
LYNNWOOD
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98036-4746
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-563-1500
Provider Business Mailing Address Fax Number:
425-563-1374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19020 33RD AVE W
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
LYNNWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98036-4746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-563-1500
Provider Business Practice Location Address Fax Number:
425-563-1374
Provider Enumeration Date:
03/06/2007

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: 2085R0202X , with the licence number:  MD00047291 , 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)

  • Identifier: G8882841 . This is a "PTAN-TRA PIERCE CO" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: G8883120 . This is a "PTAN-MIO1" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: LNI EVERGREEN RADIA . This is a "0354223" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: LNI SWEDISH RADIA . This is a "0354221" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0251374 . This is a "LABOR AND INDUSTRIES-TRA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0251390 . This is a "LABOR AND INDUSTRIES-UNION AVENUE OPEN MRI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: LNI RADIA-KING CTY . This is a "0354217" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0251385 . This is a "LABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 2001566 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: G8882842 . This is a "PTAN-TRA KING CO" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: G8882900 . This is a "PTAN-UAOM" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: LNI RADIA-REST OF WA . This is a "0354216" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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