Provider Demographics
NPI:1063487494
Name:KUMAR, SAJAL (MD)
Entity Type:Individual
Prefix:
First Name:SAJAL
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 HOLTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3254
Mailing Address - Country:US
Mailing Address - Phone:509-248-6292
Mailing Address - Fax:509-248-9134
Practice Address - Street 1:315 HOLTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3254
Practice Address - Country:US
Practice Address - Phone:509-248-6292
Practice Address - Fax:509-248-9134
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7347207RN0300X
WAMD60076892207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7140726Medicaid
WA7140726Medicaid