Provider Demographics
NPI:1225484207
Name:BANSAL, JASH (MD)
Entity Type:Individual
Prefix:
First Name:JASH
Middle Name:
Last Name:BANSAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3111 WOBURN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-6610
Mailing Address - Country:US
Mailing Address - Phone:360-543-5054
Mailing Address - Fax:360-733-1659
Practice Address - Street 1:3111 WOBURN ST STE 201
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6610
Practice Address - Country:US
Practice Address - Phone:360-543-5054
Practice Address - Fax:360-733-1659
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD61283798207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology