Individual
KAVITHA CHUNCHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4420 76TH ST NE, MARYSVILLE, WA 98270-3726
(425) 259-0966
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60077669
WA
207Q00000X
Family Medicine Physician
ML20008504
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008581
—
WA
Enumeration date
08/13/2006
Last updated
03/22/2024
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