MEDICARE: DR. RAMAN SASI MENON 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	208C00000X	Colon & Rectal Surgery Physician	MD60131001	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

General Provider Information

NPI Number	:	1730378092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMAN SASI MENON MD

Provider Business Mailing Address
First Line	:	PO BOX 25608
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84125-0608
Country	:	US
Telephone Number	:	206-320-4476
Fax Number	:	206-568-7043

Provider Business Practice Location Address
First Line	:	1101 MADISON ST STE 510
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-3557
Country	:	US
Telephone Number	:	206-386-6600
Fax Number	:	206-386-2452

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

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	10/12/2023

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