MEDICARE: GIANNOULA TANSARLI MD, PHD

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	207ZC0006X	Clinical Pathology Physician	MD61488975	WA
2	207ZM0300X	Medical Microbiology Physician	MD61488975	WA

General Provider Information

NPI Number	:	1255918447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIANNOULA TANSARLI MD, PHD

Provider Business Mailing Address
First Line	:	PO BOX 50095
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98145-5095
Country	:	US
Telephone Number	:	206-520-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-2855
Country	:	US
Telephone Number	:	401-400-9118
Fax Number	:

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

Provider Enumeration Date	:	03/25/2021
Last Update Date	:	01/29/2025

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