Healthcare Provider Details

I. General information

NPI: 1609309426
Provider Name (Legal Business Name): MOHINI DASARI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 24TH ST STE 700
ANACORTES WA
98221-2595
US

IV. Provider business mailing address

1211 24TH ST
ANACORTES WA
98221-2562
US

V. Phone/Fax

Practice location:
  • Phone: 360-293-5142
  • Fax:
Mailing address:
  • Phone: 360-299-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD61186244
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: