Healthcare Provider Details
I. General information
NPI: 1982679585
Provider Name (Legal Business Name): PARAG M RAMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/17/2006
Last Update Date: 09/14/2024
Certification Date: 09/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1304 FAWCETT AVE STE 100
TACOMA WA
98402-1900
US
IV. Provider business mailing address
8375 W LA CAILLE
PEORIA AZ
85383-1305
US
V. Phone/Fax
- Phone: 253-761-4200
- Fax:
- Phone: 623-628-6193
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 332480 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | 01067581A |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 33043 |
| License Number State | AZ |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | A102453 |
| License Number State | CA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | 33043 |
| License Number State | AZ |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | MD61012033 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: