Healthcare Provider Details

I. General information

NPI: 1205110202
Provider Name (Legal Business Name): REAH MARY KURIAN ALAPPAT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2011
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34503 9TH AVE S STE 330
FEDERAL WAY WA
98003-8726
US

IV. Provider business mailing address

34503 9TH AVE S STE 330
FEDERAL WAY WA
98003-8726
US

V. Phone/Fax

Practice location:
  • Phone: 253-835-8850
  • Fax: 253-835-8869
Mailing address:
  • Phone: 253-835-8850
  • Fax: 253-835-8869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2013023321
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD61314374
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: