Basic Information
| Provider Information | |||||||||
| NPI: | 1831185966 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOHAI | ||||||||
| FirstName: | PETER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3489 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981143489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063869500 | ||||||||
| FaxNumber: | 2063869605 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 MINOR AVE | ||||||||
| Address2: | STE 300 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981042120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063869500 | ||||||||
| FaxNumber: | 2063869605 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2005 | ||||||||
| LastUpdateDate: | 03/06/2008 | ||||||||
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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 | 207RR0500X | MD00015425 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 5891740001 | 01 | WA | DME | OTHER | 760113330 | 01 | WA | PALMETTO RR MEDICARE | OTHER | 1616002 | 05 | WA | MEDICAID | MO8931 | 01 | WA | REGENCE | OTHER | 78934 | 01 | WA | LABOR & INDUSTRY | OTHER |