Healthcare Provider Details

I. General information

NPI: 1902149339
Provider Name (Legal Business Name): APARNA RADHAKISAN BAHETI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 S UNION AVE
TACOMA WA
98405-1328
US

IV. Provider business mailing address

32014 32ND AVE S
FEDERAL WAY WA
98001-9625
US

V. Phone/Fax

Practice location:
  • Phone: 253-841-4653
  • Fax: 253-446-3973
Mailing address:
  • Phone: 253-874-7107
  • Fax: 253-874-1923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number336448
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number71150
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0116025756
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD61367722
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number205466
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD-26930
License Number StateHI
# 8
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD61067485
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: