Individual
DR. GAUTHAM P. REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-6200
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD60021351
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0241423
L&I
WA
05
—
1538101456
—
WA
Enumeration date
06/12/2006
Last updated
09/26/2012
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