Basic Information
| Provider Information | |||||||||
| NPI: | 1033539903 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAINTH | ||||||||
| FirstName: | AMIT | ||||||||
| MiddleName: | SINGH | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1959 NE PACIFIC ST BOX 356410 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981956410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065433687 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3355 RIVERBEND DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974778800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5418689303 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2014 | ||||||||
| LastUpdateDate: | 03/07/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 11/21/2014 | ||||||||
| NPIReactivationDate: | 01/08/2015 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | MD201688 | OR | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 208600000X | MD201688 | OR | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.