Provider Demographics
NPI:1427634542
Name:GADI, DEEKSHA
Entity type:Individual
Prefix:
First Name:DEEKSHA
Middle Name:
Last Name:GADI
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 1:920 N 34TH ST APT 49
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8879
Mailing Address - Country:US
Mailing Address - Phone:404-513-5770
Mailing Address - Fax:
Practice Address - Street 1:920 N 34TH ST APT 49
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8879
Practice Address - Country:US
Practice Address - Phone:404-513-5770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61586646363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP61586646OtherWASHINGTON BOARD OF NURSING