Provider Demographics
NPI:1134919491
Name:RABADIA, PRIYA VIRAL
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:VIRAL
Last Name:RABADIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29689 130TH WAY SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-3225
Mailing Address - Country:US
Mailing Address - Phone:253-332-9678
Mailing Address - Fax:
Practice Address - Street 1:7084 LAKELAND HILLS WAY SE STE 104
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8439
Practice Address - Country:US
Practice Address - Phone:253-329-5083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2255A2300X, 390200000X
FL390200000X
WA700189481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program