Healthcare Provider Details

I. General information

NPI: 1336405539
Provider Name (Legal Business Name): MICHAEL ADEL ESKANDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 YAKIMA AVE STE 307
TACOMA WA
98405-5305
US

IV. Provider business mailing address

1802 YAKIMA AVE STE 307
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 Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD61043235
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD61043235
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: