Provider Demographics
NPI:1194755819
Name:BHASKAR, KAREN E (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:BHASKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:E
Other - Last Name:WUERTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11011 MERIDIAN AVE N
Mailing Address - Street 2:STE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8967
Mailing Address - Country:US
Mailing Address - Phone:206-860-4550
Mailing Address - Fax:
Practice Address - Street 1:11011 MERIDIAN AVE N
Practice Address - Street 2:STE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8967
Practice Address - Country:US
Practice Address - Phone:206-860-4550
Practice Address - Fax:206-720-7437
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60509349207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8954529Medicare UPIN
F80516Medicare UPIN