Healthcare Provider Details

I. General information

NPI: 1154768026
Provider Name (Legal Business Name): BINDUPRIYA CHANDRASEKARAN M.D., M.R.C.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BINDU CHANDRASEKARAN M.D., M.R.C.S

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 S I ST STE 204
TACOMA WA
98405-5092
US

IV. Provider business mailing address

1624 S I ST STE 204
TACOMA WA
98405-5092
US

V. Phone/Fax

Practice location:
  • Phone: 253-752-8882
  • Fax: 253-590-0260
Mailing address:
  • Phone: 253-752-8882
  • Fax: 253-590-0260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01083882A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberT1662
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD61388371
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD61388371
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: