Healthcare Provider Details

I. General information

NPI: 1730265497
Provider Name (Legal Business Name): PATHMAJA PARAMSOTHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MADISON ST STE 301
SEATTLE WA
98104-3599
US

IV. Provider business mailing address

1200 12TH AVE S
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-505-1101
  • Fax: 206-505-1277
Mailing address:
  • Phone: 206-621-4503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD00041089
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: