Healthcare Provider Details

I. General information

NPI: 1407952674
Provider Name (Legal Business Name): SATISH SUBRAMANIAM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 09/11/2025
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 196TH ST SW
LYNNWOOD WA
98036-5518
US

IV. Provider business mailing address

40 DUKE MEDICINE CIR # DUMC 3148
DURHAM NC
27710-4000
US

V. Phone/Fax

Practice location:
  • Phone: 425-640-5115
  • Fax:
Mailing address:
  • Phone: 919-684-3136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD00033191
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: