Healthcare Provider Details

I. General information

NPI: 1609886290
Provider Name (Legal Business Name): SANJIV TEWARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 COLBY AVE
EVERETT WA
98201-1665
US

IV. Provider business mailing address

224 W. EXCHANGE ST SUITE 380
AKRON OH
44302
US

V. Phone/Fax

Practice location:
  • Phone: 425-404-8227
  • Fax:
Mailing address:
  • Phone: 330-344-6676
  • Fax: 330-434-3611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD70035780
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD70035780
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME152385
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: