Healthcare Provider Details

I. General information

NPI: 1679067953
Provider Name (Legal Business Name): NAYAN KISHORI BHATNAGAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 164TH AVE. NE SUITE #A215
REDMOND WA
98052
US

IV. Provider business mailing address

7530 164TH AVE. NE SUITE #A215
REDMOND WA
98052
US

V. Phone/Fax

Practice location:
  • Phone: 425-885-9292
  • Fax: 425-885-9106
Mailing address:
  • Phone: 718-579-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD61154358
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: