Healthcare Provider Details

I. General information

NPI: 1336767656
Provider Name (Legal Business Name): NAVYAMANI VENKATA DURGA KAGITA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 YAKIMA AVE STE 205
TACOMA WA
98405-5300
US

IV. Provider business mailing address

1708 YAKIMA AVE STE 205
TACOMA WA
98405-5300
US

V. Phone/Fax

Practice location:
  • Phone: 253-565-6777
  • Fax: 253-566-8777
Mailing address:
  • Phone: 253-565-6777
  • Fax: 253-566-8777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD61614967
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: