1942060694 NPI number — PRIYANKA VILAS PRAJAPATI

Table of content: PRIYANKA VILAS PRAJAPATI (NPI 1942060694)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942060694 NPI number — PRIYANKA VILAS PRAJAPATI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRAJAPATI
Provider First Name:
PRIYANKA
Provider Middle Name:
VILAS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942060694
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1959 NE PACIFIC STREET, BOX 356365
Provider Second Line Business Mailing Address:
ROOM B-440
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98195-3635
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-543-0903
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1959 NE PACIFIC STREET
Provider Second Line Business Practice Location Address:
ROOM B-440
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98195-3635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-543-0903
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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