Healthcare Provider Details

I. General information

NPI: 1013177237
Provider Name (Legal Business Name): ASHOK SHIMOJI-KRISHNAN MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. ASHOK KRISHNAN

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13451 SE 36TH ST
BELLEVUE WA
98006-1475
US

IV. Provider business mailing address

13451 SE 36TH ST
BELLEVUE WA
98006-1475
US

V. Phone/Fax

Practice location:
  • Phone: 425-562-1337
  • Fax: 425-562-3802
Mailing address:
  • Phone: 425-562-1337
  • Fax: 425-562-3802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD60221539
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: