Healthcare Provider Details

I. General information

NPI: 1497147094
Provider Name (Legal Business Name): TELEHOSPITALIST SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 NE 65TH ST
SEATTLE WA
98115-7228
US

IV. Provider business mailing address

3113 NE 65TH ST
SEATTLE WA
98115-7228
US

V. Phone/Fax

Practice location:
  • Phone: 800-924-8140
  • Fax:
Mailing address:
  • Phone: 800-924-8140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-33447
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-33447
License Number StateKS

VIII. Authorized Official

Name: ELISHA YAGHMAI
Title or Position: PRESIDENT
Credential:
Phone: 800-924-8140