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Individual

DR. MYTHILI R RAMACHANDRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
17500 SE 392ND ST, AUBURN, WA 98092-9705
(253) 294-8201
(253) 333-3612
Mailing address
21509 HWY 410 E, SUITE 1, BONNEY LAKE, WA 98391-4190
(253) 891-2160
(253) 891-2171

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00036489
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1117456
WA
01
126641
LABOR & INDUSTRIES
WA
01
201130800
DOL
01
5801754
AETNA
WA
01
AR6157
REGENCE BLUE SHEILD RIDER
WA
01
P00070741
MEDICARE RAILROAD
Enumeration date
04/20/2006
Last updated
04/16/2025
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