Healthcare Provider Details

I. General information

NPI: 1750737490
Provider Name (Legal Business Name): SRAVYA P. VAJAPEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7315 212TH ST SW STE 101
EDMONDS WA
98026-7610
US

IV. Provider business mailing address

PO BOX 741515
LOS ANGELES CA
90074-1515
US

V. Phone/Fax

Practice location:
  • Phone: 425-775-9474
  • Fax: 425-670-3554
Mailing address:
  • Phone: 425-775-9474
  • Fax: 425-670-3554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number287831
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberMD61268002
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD61268002
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: