# DR. SHAISTA QUDDUSI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1053340885
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | MD00032808 | WA | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | MD00032808 | WA | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 12/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0195405 | L & I | WA |
| 01 | — | 0205416 | L & I | WA |
| 01 | — | 04301438 | ECFMG | WA |
| 05 | — | 8228041 | — | WA |
| 01 | — | 8904723 | CRIME VICTIMS | WA |
| 01 | — | 8940048 | CRIME VICTIMS | WA |
| 01 | — | P00181501 | RAILROAD | WA |