Healthcare Provider Details
I. General information
NPI: 1346702719
Provider Name (Legal Business Name): JASMEET RICKY GARCHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/03/2019
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
33501 1ST WAY S
FEDERAL WAY WA
98003-6208
US
IV. Provider business mailing address
PO BOX 741515
LOS ANGELES CA
90074-1515
US
V. Phone/Fax
- Phone: 253-838-2400
- Fax: 253-874-1637
- Phone: 253-838-2400
- Fax: 253-874-1637
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 390200000X |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD70043230 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: