Provider Demographics
NPI:1114337722
Name:WELLS, MONIKA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:MONIKA
Other - Middle Name:
Other - Last Name:KASINA
Other - Suffix:
Other - Last Name Type:Former Name
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 1:925 SENECA STREET MAILSTOP H8-GME
Practice Address - Street 2:VIRGINIA MASON MEDICAL CENTER
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-583-6079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60715092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine