MEDICARE: KARINA MIRCHANDANI

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1174932164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARINA MIRCHANDANI

Provider Business Mailing Address
First Line	:	4791 STERLING WAY APT 302
Second Line	:
City	:	MUKILTEO
State	:	WA
Zip	:	98275-6049
Country	:	US
Telephone Number	:	630-849-9524
Fax Number	:

Provider Business Practice Location Address
First Line	:	8117 STONE AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4414
Country	:	US
Telephone Number	:	206-535-8876
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	08/05/2014

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Directions to “ KARINA MIRCHANDANI ” Practice Location

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