Individual
PRAVEEN KUMAR MAMBALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21616 76TH AVE W, STE 102, EDMONDS, WA 98026-7512
(425) 774-1538
(425) 744-1527
Mailing address
PO BOX 827, BELLEVUE, WA 98009-0827
(425) 774-1538
(425) 744-1527
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD 00049423
WA
Other
Enumeration date
05/17/2008
Last updated
05/23/2023
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