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General NPI Number Information
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NPI Number | 1477998599
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Entity Type | Individual
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Provider Name | KAYLESH K. PANDYA D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 625 W RAILROAD AVE # 234
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City | SHELTON
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State | WA
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Zip | 98584-3522
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Country | US
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Telephone | 360-529-1234
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Fax | 360-284-2535
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Provider Business Mailing Address
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Address Line | 625 W RAILROAD AVE # 234
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City | SHELTON
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State | WA
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Zip | 98584-3522
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Country | US
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Telephone | 360-529-1234
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Fax | 360-284-2535
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | OS14868
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS14868
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP61475133
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License Number State | WA
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