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1437148749

NPI Code Detail

MEDICARE: DR. PANKAJ RAJVANSHI MD

MEDICARE: DR. PANKAJ RAJVANSHI 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
1	207R00000X	Internal Medicine Physician	MD00036106	WA
2	207RG0100X	Gastroenterology Physician	MD00036106	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437148749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PANKAJ RAJVANSHI MD

Provider Business Mailing Address
First Line	:	4011 TALBOT RD S STE 500
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98055-5782
Country	:	US
Telephone Number	:	425-690-3488
Fax Number	:	425-690-9088

Provider Business Practice Location Address
First Line	:	4011 TALBOT RD S STE 500
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98055-5782
Country	:	US
Telephone Number	:	425-690-3488
Fax Number	:	425-690-9088

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	03/13/2022

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Directions to “ DR. PANKAJ RAJVANSHI MD” Practice Location

Language	Start Address	Practice Location

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