Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD00046476 | WA |
NPI | 1164528790 |
---|---|
Provider Name | Dr. Rupin Raj Thakkar |
First Address | Edmonds, WA 98026-8012 |
Second Address | Edmonds, WA 98026-8012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 09/10/2020 |