Individual
SRIDAR CHALAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3901 HOYT AVE, EVERETT, WA 98201-4918
(425) 339-5410
(425) 257-1433
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD00034833
WA
207RP1001X
Pulmonary Disease Physician
Primary
MD00034833
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0114209
LABOR AND INDUSTRY
WA
05
—
1017776
—
WA
01
—
290009806
RAILROAD MEDICARE
WA
05
—
8207292
—
WA
01
—
MD00034833
STATE LICENSE NUMBER
WA
Enumeration date
05/25/2006
Last updated
12/06/2012
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