Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 036.110676 | IL |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD61238319 | WA |
NPI | 1043388812 |
---|---|
Provider Name | Padma Srigiriraju |
First Address | Everett, WA 98201-4147 |
Second Address | Everett, WA 98201-4147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 10/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036110676 | (05) | IL |