Healthcare Provider Details

I. General information

NPI: 1184156150
Provider Name (Legal Business Name): ANNA V GARDELLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA SUBRAMANIAM MD

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W 5TH AVE STE 900
SPOKANE WA
99204-2948
US

IV. Provider business mailing address

PO BOX 5299 MS: 820-5-PCO
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 509-755-5500
  • Fax: 509-744-1741
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD.MD.61519150
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD.MD.61519150
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: