Individual
MR. VIMUKTA MAHADEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1959 NE PACIFIC ST, BOX 356410, SEATTLE, WA 98195-6410
(714) 397-5742
Mailing address
1959 NE PACIFIC ST, BOX 356410, SEATTLE, WA 98195-6410
(714) 397-5742
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD61017974
WA
Other
Enumeration date
04/14/2015
Last updated
10/05/2021
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