Individual
JAYA MADHAV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 NE 87TH AVE STE 220, VANCOUVER, WA 98664-4896
(360) 882-2778
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD61082233
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2165746
—
WA
Enumeration date
04/23/2015
Last updated
01/11/2021
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