Individual
ANSAB KHWAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PC
Contact information
Practice address
625 9TH AVE STE 210, LONGVIEW, WA 98632-2465
(360) 501-3400
(360) 423-5682
Mailing address
625 9TH AVE STE 210, LONGVIEW, WA 98632-2465
(360) 501-3400
(360) 423-5682
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R75494
AZ
207X00000X
Orthopaedic Surgery Physician
70189
CT
207X00000X
Orthopaedic Surgery Physician
Primary
FK1223750
WA
207X00000X
Orthopaedic Surgery Physician
Primary
MD214297
OR
207X00000X
Orthopaedic Surgery Physician
R75494
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366896797
—
WA
Enumeration date
04/21/2016
Last updated
03/12/2026
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