Healthcare Provider Details

I. General information

NPI: 1821982893
Provider Name (Legal Business Name): PLATINUM PEAKS HEALTHCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 S UNION AVE
TACOMA WA
98409-3317
US

IV. Provider business mailing address

917 PACIFIC AVE STE 600
TACOMA WA
98402-4437
US

V. Phone/Fax

Practice location:
  • Phone: 253-844-4327
  • Fax: 888-871-0613
Mailing address:
  • Phone: 253-844-4327
  • Fax: 888-871-0613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MANOJ WADHWANI
Title or Position: OWNER
Credential:
Phone: 203-901-2493