Individual
DR. SHAKUNTHALA REVANNAGOWDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-3901
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
MD60998671
WA
2085R0202X
Diagnostic Radiology Physician
MD60998671
WA
Other
Enumeration date
06/01/2016
Last updated
05/10/2022
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