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Individual

PRAGATHY VUTLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1717 S J ST, MS 01-36, TACOMA, WA 98405-4933
(253) 426-6363
Mailing address
1717 S J ST, MS 01-36, TACOMA, WA 98405-4933
(253) 426-6363
(253) 426-6344

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
226667
MA
207R00000X
Internal Medicine Physician
Primary
MD00045419
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0248725
STATE L & I
WA
Enumeration date
05/02/2006
Last updated
05/15/2011
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