Healthcare Provider Details

I. General information

NPI: 1326331521
Provider Name (Legal Business Name): ANIL JOSEPH KULANGARA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-1010
  • Fax:
Mailing address:
  • Phone: 206-762-1010
  • Fax: 719-526-7732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD60797252
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD60797252
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: