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Individual

GANGA PINGILI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2835 82ND AVE SE STE 210, MERCER ISLAND, WA 98040-3055
(206) 236-3030
(206) 204-0808
Mailing address
2835 82ND AVE SE STE 210, MERCER ISLAND, WA 98040-3055
(206) 236-3030
(206) 204-0808

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
60188439
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003130
STATE OF GEORGIA
GA
05
621341781A
GA
Enumeration date
06/18/2006
Last updated
10/02/2015
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