Provider Demographics
NPI:1184688152
Name:RAKSHA V TRIVEDI MD PS
Entity Type:Organization
Organization Name:RAKSHA V TRIVEDI MD PS
Other - Org Name:AVANI WOMENS HEALTH & ASTHETICS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAKSHA
Authorized Official - Middle Name:VANDAN
Authorized Official - Last Name:TRIVEDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-362-3313
Mailing Address - Street 1:1560 N 115TH ST STE 108
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8414
Mailing Address - Country:US
Mailing Address - Phone:206-362-3113
Mailing Address - Fax:206-364-2625
Practice Address - Street 1:1560 N 115TH ST STE 108
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8414
Practice Address - Country:US
Practice Address - Phone:206-362-3113
Practice Address - Fax:206-364-2625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00016453207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1841402Medicaid
WA160000681Medicare PIN
WAG000105474Medicare PIN
WAA05810Medicare UPIN