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Individual

DR. SHRAVANA DEEPTHI GUDIVADA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
402 15TH AVE SE STE 201, PUYALLUP, WA 98372-3709
(253) 697-5250
Mailing address
402 15TH AVE SE STE 201, PUYALLUP, WA 98372-3709
(253) 697-5250

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125068551
IL
2084N0400X
Neurology Physician
Primary
MD61036197
WA

Other

Enumeration date
06/24/2016
Last updated
09/06/2023
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