Individual
SURAJ REDDY MUDDASANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1703 S MERIDIAN STE 101, PUYALLUP, WA 98371-7590
(253) 446-3904
Mailing address
1703 S MERIDIAN STE 101, PUYALLUP, WA 98371-7590
(253) 446-3904
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD61657223
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2021
Last updated
08/20/2025
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