Healthcare Provider Details
I. General information
NPI: 1205240967
Provider Name (Legal Business Name): NINEL HOVNANIANS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/19/2014
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1536 N 115TH ST STE 200
SEATTLE WA
98133-8400
US
IV. Provider business mailing address
PO BOX 50095
SEATTLE WA
98145-5095
US
V. Phone/Fax
- Phone: 718-918-5000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | BC61191813 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: