MEDICARE: VINAYA B CHEPURI 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	207RC0000X	Cardiovascular Disease Physician	MD.MD.00030762	WA
2	207RI0011X	Interventional Cardiology Physician	MD.MD.00030762	WA

General Provider Information

NPI Number	:	1588611347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINAYA B CHEPURI MD

Provider Business Mailing Address
First Line	:	1728 W MARINE VIEW DR STE 110
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98201-2094
Country	:	US
Telephone Number	:	425-225-2700
Fax Number	:	425-225-2790

Provider Business Practice Location Address
First Line	:	12728 19TH AVE SE STE 200
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98208-6676
Country	:	US
Telephone Number	:	425-225-2700
Fax Number	:	425-225-2790

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	06/05/2026

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