Individual
MONICA SHANTA VAVILALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
HARBORVIEW MEDICAL CENTER, 325 9TH AVE, SEATTLE, WA 98104
(206) 731-3000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00031742
WA
208000000X
Pediatrics Physician
MD00031742
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0232118
L&I
WA
01
—
050057264
RAILROAD MEDICARE
WA
05
—
1740347947
—
WA
01
—
3186
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
01/03/2007
Last updated
02/14/2012
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