Individual
AJAY VENKATARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 S J ST STE 336, TACOMA, WA 98405-4933
(253) 426-4101
(253) 426-6936
Mailing address
1810 SUMMIT POINTE DR, SCRANTON, PA 18508
(570) 877-3988
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60715854
WA
Other
Enumeration date
06/24/2014
Last updated
10/28/2022
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