Individual
BASAVARAJ V GHODKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 731-3105
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
TR00042986
WA
2085N0700X
Neuroradiology Physician
TR00042986
WA
2085R0202X
Diagnostic Radiology Physician
TR00042986
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0231066
L&I
WA
05
—
1336269265
—
WA
01
—
P00114521
RAILROAD MEDICARE
WA
Enumeration date
04/02/2007
Last updated
02/28/2025
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