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NPI Code Detail

MEDICARE: DR. PAVANI GINGRICH MD

MEDICARE: DR. PAVANI GINGRICH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine PhysicianMD61676971WA

General Provider Information

NPI Number : 1053061531
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAVANI GINGRICH MD
Provider Business Mailing Address
First Line : 1498 PACIFIC AVE
Second Line :
City : TACOMA
State : WA
Zip : 98402-4208
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 315 MARTIN LUTHER KING JR WAY
Second Line :
City : TACOMA
State : WA
Zip : 98405-4234
Country : US
Telephone Number : 253-403-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2022
Last Update Date : 03/27/2026

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Directions to “ DR. PAVANI GINGRICH MD” Practice Location

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