Healthcare Provider Details

I. General information

NPI: 1083537971
Provider Name (Legal Business Name): SEATTLEHEART LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 116TH AVE NE # E210
BELLEVUE WA
98004-3819
US

IV. Provider business mailing address

1407 116TH AVE NE # E210
BELLEVUE WA
98004-3819
US

V. Phone/Fax

Practice location:
  • Phone: 718-772-3356
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: BHANU GUPTA
Title or Position: OWNER
Credential: MD
Phone: 718-772-3356