Healthcare Provider Details

I. General information

NPI: 1740110832
Provider Name (Legal Business Name): INSHAN MAGARATI PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: INSHAN MAGARATI-SHREESH

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7124 RADIUS LOOP SE
LACEY WA
98513-5140
US

IV. Provider business mailing address

7124 RADIUS LOOP SE
LACEY WA
98513-5140
US

V. Phone/Fax

Practice location:
  • Phone: 832-279-4054
  • Fax:
Mailing address:
  • Phone: 832-279-4054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: