Provider Demographics
NPI:1336132232
Name:RAI, NAVDEEP S (MD)
Entity Type:Individual
Prefix:
First Name:NAVDEEP
Middle Name:S
Last Name:RAI
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 1:34509 9TH AVE S STE 104
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8707
Mailing Address - Country:US
Mailing Address - Phone:253-572-5140
Mailing Address - Fax:253-750-6100
Practice Address - Street 1:34509 9TH AVE S STE 104
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8707
Practice Address - Country:US
Practice Address - Phone:253-572-5140
Practice Address - Fax:253-750-6100
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA39636207R00000X, 207RC0200X, 207RP1001X
WAMD00039636207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA290013813OtherRR MEDICARE
WA8279358Medicaid
WA1007936Medicaid
WAGAB34381-KING COMedicare PIN
WAGAB21746-PIERCE COMedicare PIN