Basic Information
| Provider Information | |||||||||
| NPI: | 1376576801 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHROFF | ||||||||
| FirstName: | ASHOK | ||||||||
| MiddleName: | BASANT | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 46329 SE 131ST ST | ||||||||
| Address2: | |||||||||
| City: | NORTH BEND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980458857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255034336 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14841 179TH AVE SE | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | MONROE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982721127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608631508 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 11/05/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD00030088 | WA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.