Individual
DR. RAVI SIVASANKARA MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
747 BROADWAY, SEATTLE, WA 98122-4379
(206) 215-3958
(206) 320-2451
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 233-7489
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
D0065029
MD
2084N0400X
Neurology Physician
MD036298
DC
2084N0400X
Neurology Physician
Primary
MD60333790
WA
2084V0102X
Vascular Neurology Physician
MD60333790
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326160177
—
WA
01
—
G8918460
MEDICARE PIN SNOHOMISH
WA
Enumeration date
04/04/2007
Last updated
07/01/2021
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