MEDICARE: DR. SHWETIHA RAJAGOPAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	61672678	WA

General Provider Information

NPI Number	:	1831833086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHWETIHA RAJAGOPAL MD

Provider Business Mailing Address
First Line	:	1035 116TH AVE NE
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-4604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22630 SE 4TH ST STE 300
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7131
Country	:	US
Telephone Number	:	425-635-3070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	05/31/2026

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