Provider Demographics
NPI:1346447836
Name:O'REILLY-SHAH, VIKAS N (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKAS
Middle Name:N
Last Name:O'REILLY-SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:VIKAS
Other - Middle Name:N
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4118 42ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5125
Mailing Address - Country:US
Mailing Address - Phone:615-335-3808
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE # 11525
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:615-335-3808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60915991207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFA374YMedicare PIN
CAFA374ZMedicare PIN