Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 57020645 | OH |
N | 111NI0900X | Internist | 57020645 | OH |
N | 207RH0003X | Hematology & Oncology | R10172 | IA |
Y | 207RX0202X | Medical Oncology | MD60960073 | WA |
NPI | 1003171976 |
---|---|
Provider Name | Vyshak Alva Venur |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98109-4405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2012 |
Last Update Date | 18/03/2020 |