Healthcare Provider Details

I. General information

NPI: 1013278316
Provider Name (Legal Business Name): MANPREET SINGH SRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2012
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17875 REDMOND WAY STE 140
REDMOND WA
98052-4936
US

IV. Provider business mailing address

15 S GRADY WAY STE 433
RENTON WA
98057-3219
US

V. Phone/Fax

Practice location:
  • Phone: 599-499-3370
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number60725254
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number18732
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberQ9522
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: