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Individual

THIRAN UDAWATTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2979 SQUALICUM PKWY STE 203, BELLINGHAM, WA 98225-1813
(360) 733-7670
(360) 647-1901
Mailing address
2979 SQUALICUM PKWY STE 203, BELLINGHAM, WA 98225-1813
(360) 733-7670
(360) 647-1901

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD61031268
WA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
MD61031268
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2154392
WA
01
440477
WA LABOR & INDUSTRIES
WA
Enumeration date
05/25/2014
Last updated
08/26/2021
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