Healthcare Provider Details

I. General information

NPI: 1700891900
Provider Name (Legal Business Name): MANOJ AGARWAL MD, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16233 SYLVESTER RD SW STE 110
BURIEN WA
98166-3044
US

IV. Provider business mailing address

16233 SYLVESTER RD SW STE 110
BURIEN WA
98166-3044
US

V. Phone/Fax

Practice location:
  • Phone: 206-439-5577
  • Fax: 206-241-4429
Mailing address:
  • Phone: 206-439-5577
  • Fax: 206-241-4429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD61246647
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD61246647
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: