| Northwest Neurology And Edx Center | |
|
914 D St Ne Ste 103 Auburn WA 98002-4163 | |
| (253) 333-1637 | |
| (253) 351-8509 |
| Full Name | Northwest Neurology And Edx Center |
|---|---|
| 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 |
|---|---|
| Northwest Neurology And Edx Center 914 D St Ne Ste 103 Auburn WA 98002-4163 Ph: (253) 333-1637 | Northwest Neurology And Edx Center 914 D St Ne Ste 103 Auburn WA 98002-4163 Ph: (253) 333-1637 |
| NPI Number | 1174143887 |
|---|---|
| Provider Enumeration Date | 04/22/2020 |
| Last Update Date | 12/13/2022 |
| Certification Date | 01/17/2022 |
| Medicare PECOS PAC ID | 3779914049 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134177413 PECOS PAC ID: 4284626938 Enrollment ID: I20040401000757 |
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