Healthcare Provider Details

I. General information

NPI: 1023549490
Provider Name (Legal Business Name): KARISHMA A DARA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720 14TH AVE S
SEATTLE WA
98108-4807
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-1703
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-3730
  • Fax: 206-764-0523
Mailing address:
  • Phone: 253-681-6626
  • Fax: 206-764-0523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD61047319
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: