Healthcare Provider Details

I. General information

NPI: 1093027088
Provider Name (Legal Business Name): MOHAN ASHOK KUMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 YAKIMA AVE STE 304
TACOMA WA
98405-5305
US

IV. Provider business mailing address

1802 YAKIMA AVE STE 304
TACOMA WA
98405-5305
US

V. Phone/Fax

Practice location:
  • Phone: 253-627-1244
  • Fax: 253-627-6576
Mailing address:
  • Phone: 253-627-1244
  • Fax: 253-627-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR71968
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMT203350
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD60600125
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: