Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO60841435 | WA |
NPI | 1003202870 |
---|---|
Provider Name | Padhma Venkitapathy |
First Address | Renton, WA 98057-4970 |
Second Address | Renton, WA 98055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 25/09/2019 |