Healthcare Provider Details

I. General information

NPI: 1124093372
Provider Name (Legal Business Name): VASANT G HALARNAKAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 09/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E OLIVE ST SOUND MENTAL HEALTH
SEATTLE WA
98122-2735
US

IV. Provider business mailing address

1600 E. OLIVE ST. SOUND MENTAL HEALTH
SEATTLE WA
98122
US

V. Phone/Fax

Practice location:
  • Phone: 206-302-2200
  • Fax: 206-302-2210
Mailing address:
  • Phone: 206-302-2200
  • Fax: 206-302-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberWA00028516
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: