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General NPI Number Information
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NPI Number | 1407738693
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Entity Type | Individual
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Provider Name | ANANYA MANDYAM
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Gender | Female
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 753 N 35TH ST
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City | SEATTLE
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State | WA
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Zip | 98103-8870
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Country | US
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Telephone | 206-462-5830
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Fax |
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Provider Business Mailing Address
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Address Line | 3997 170TH PL NE
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City | BELLEVUE
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State | WA
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Zip | 98008-6134
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Country | US
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Telephone | 425-533-1845
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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