MEDICARE: DR. SIKIRAT I TINUBU-KARCH 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	174400000X	Specialist	MD00034253	WA
2	207R00000X	Internal Medicine Physician	MD00034253	WA
3	207QG0300X	Geriatric Medicine (Family Medicine) Physician	MD00034253	WA

General Provider Information

NPI Number	:	1992733638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIKIRAT I TINUBU-KARCH MD

Provider Business Mailing Address
First Line	:	1455 NW LEARY WAY STE 400
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-5138
Country	:	US
Telephone Number	:	206-940-2136
Fax Number	:

Provider Business Practice Location Address
First Line	:	1455 NW LEARY WAY STE 400
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-5138
Country	:	US
Telephone Number	:	206-940-2136
Fax Number	:

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	07/21/2022

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