Individual
DR. VENKATESH R. KANDALLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 10TH ST NE, AUBURN, WA 98002-4019
(253) 939-1230
Mailing address
202 N DIVISION ST, STE 201, AUBURN, WA 98001-4939
(253) 939-1230
(253) 735-1211
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD00035482
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0280779
STATE L&I
WA
01
—
0280788
STATE L&I
WA
01
—
0280798
STATE L&I
WA
05
—
8214868
—
WA
Enumeration date
04/04/2006
Last updated
09/26/2014
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