Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | MD60751368 | WA |
NPI | 1679906580 |
---|---|
Provider Name | Dr. Kiran Gangadhar |
First Address | Lynnwood, WA 98036-4748 |
Second Address | Seattle, WA 98195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2013 |
Last Update Date | 11/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0390729 | LNI-RADIA REST OF WA (01) | WA |
0390730 | LNI-RADIA KING COUNTY (01) | WA |
0390731 | LNI-SWEDISH RADIA EDMONDS (01) | WA |
0390732 | LNI-EVERGREEN RADIA (01) | WA |
1679906580 | (05) | WA |
2036468 | (05) | WA |