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Individual

DR. SHAISTA QUDDUSI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
700 S 320TH ST, SUITE D, FEDERAL WAY, WA 98003-4691
(253) 880-1029
Mailing address
700 S 320TH ST,, ADVANCED DIABETES & ENDOCRINE CARE SUITE D, FEDERAL WAY, WA 98003
(253) 880-1029

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00032808
WA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD00032808
WA

Other

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
Enumeration date
07/02/2006
Last updated
12/08/2022
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