Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MD60763695 | WA |
NPI | 1265722789 |
---|---|
Provider Name | Ranita Sana Patel |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Seattle, WA 98104-1307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 30/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1265722789 | (05) | WA |