Individual
DR. SHALINI RAO KANNEGANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
3315 S 23RD ST, STE 200, TACOMA, WA 98405-1605
(253) 552-1200
(253) 552-1239
Mailing address
3315 S 23RD ST, STE 200, TACOMA, WA 98405-1605
(253) 552-1200
(253) 552-1239
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
70957
AZ
208600000X
Surgery Physician
MD60297035
WA
208C00000X
Colon & Rectal Surgery Physician
Primary
MD60297035
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0299319
STATE L&I
WA
01
—
0299812
STATE L&I
WA
Enumeration date
08/26/2008
Last updated
01/18/2013
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