Provider Demographics
NPI:1124313846
Name:TRIPATHI, PRAGYA PRIYADARSHINI (MD)
Entity type:Individual
Prefix:
First Name:PRAGYA
Middle Name:PRIYADARSHINI
Last Name:TRIPATHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 BRONSON WAY NE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-4030
Mailing Address - Country:US
Mailing Address - Phone:425-235-2800
Mailing Address - Fax:425-235-2815
Practice Address - Street 1:275 BRONSON WAY NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-4030
Practice Address - Country:US
Practice Address - Phone:425-235-2800
Practice Address - Fax:425-235-2815
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-8820208M00000X
WAMD60895496208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist