Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD00039289 | WA |
NPI | 1134296452 |
---|---|
Provider Name | Arti S. Tayade |
First Address | Milton, WA 98354-1968 |
Second Address | Redmond, WA 98053-7680 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 10/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8266017 | (05) | WA |
AB28556 | MEDICARE ID TYPE (01) | |
H32238 | (02) | WA |