Basic Information
Provider Information
NPI: 1679529986
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DESAI
FirstName: SHILPA
MiddleName: PATEL
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PATEL
OtherFirstName: SHILPA
OtherMiddleName: AMRAT
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1101 MADISON ST
Address2: SUITE 301
City: SEATTLE
State: WA
PostalCode: 981041306
CountryCode: US
TelephoneNumber: 2065051101
FaxNumber:  
Practice Location
Address1: 1101 MADISON ST
Address2: SUITE 301
City: SEATTLE
State: WA
PostalCode: 981041306
CountryCode: US
TelephoneNumber: 2065051101
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/26/2006
LastUpdateDate: 05/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMD00046473WAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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