| |
914 D St Ne Ste 103 Auburn WA 98002-4163 | |
(253) 333-1637 | |
(253) 351-8509 |
Full Name | |
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Speciality | Psychiatry & Neurology |
Location | 914 D St Ne Ste 103, Auburn, Washington |
Authorized Official Name and Position | Ashish Trivedi (PHYSICIAN OWNER) |
Authorized Official Contact | 2539510907 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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914 D St Ne Ste 103 Auburn WA 98002-4163 Ph: (253) 333-1637 | 914 D St Ne Ste 103 Auburn WA 98002-4163 Ph: (253) 333-1637 |
NPI Number | 1174143887 |
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Provider Enumeration Date | 04/22/2020 |
Last Update Date | 12/13/2022 |
Certification Date | 01/17/2022 |
Medicare PECOS PAC ID | 3779914049 |
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Medicare Enrollment ID | O20200521000231 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174143887 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Ashish M Trivedi |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1134177413 PECOS PAC ID: 4284626938 Enrollment ID: I20040401000757 |
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