Healthcare Provider Details

I. General information

NPI: 1871912261
Provider Name (Legal Business Name): ANUREKHA GOLLAPUDI HALL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105
US

IV. Provider business mailing address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2106
  • Fax: 206-987-3946
Mailing address:
  • Phone: 206-987-2106
  • Fax: 206-987-3946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberMD60850582
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: