Provider Demographics
NPI:1164400610
Name:PARIKH, SANJIV R (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJIV
Middle Name:R
Last Name:PARIKH
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 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:509-663-8711
Mailing Address - Fax:
Practice Address - Street 1:201 16TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5226
Practice Address - Country:US
Practice Address - Phone:206-326-3000
Practice Address - Fax:877-515-2975
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000309692085R0204X, 2085R0204X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8147423Medicaid
WA120927OtherL&I PROVIDER NUMBER
WAGAB39939Medicare PIN
WA300083579Medicare PIN
WA8147423Medicaid
WAGAB02904Medicare PIN
WAG8857910Medicare PIN
WAF58184Medicare UPIN
WAP00391618Medicare PIN