Healthcare Provider Details

I. General information

NPI: 1174509293
Provider Name (Legal Business Name): VARA V KRAFT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4915 25TH AVE NE SUITE 301
SEATTLE WA
98105-5667
US

IV. Provider business mailing address

4915 25TH AVE NE SUITE 301
SEATTLE WA
98105-5667
US

V. Phone/Fax

Practice location:
  • Phone: 206-524-4737
  • Fax: 206-522-5261
Mailing address:
  • Phone: 206-524-4737
  • Fax: 206-522-5261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00032996
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: