Individual
LLEWELLYN NAYAGAM PACKIA RAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1750 112TH AVE NE STE D258, BELLEVUE, WA 98004-3727
(425) 498-2272
(425) 498-2334
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00040226
WA
208100000X
Physical Medicine & Rehabilitation Physician
MD00040226
WA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
MD00040226
WA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD00040226
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659339695
—
WA
Enumeration date
05/01/2006
Last updated
05/31/2019
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