Provider Demographics
NPI:1376639187
Name:KRISHNASWAMY, TITTE SESHADRI (MD)
Entity Type:Individual
Prefix:DR
First Name:TITTE
Middle Name:SESHADRI
Last Name:KRISHNASWAMY
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:P.O.BOX 98765
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-0765
Mailing Address - Country:US
Mailing Address - Phone:253-589-0175
Mailing Address - Fax:253-589-0175
Practice Address - Street 1:253 RIGNEY ROAD
Practice Address - Street 2:#D5
Practice Address - City:STEILACOOM
Practice Address - State:WA
Practice Address - Zip Code:98388
Practice Address - Country:US
Practice Address - Phone:253-589-0175
Practice Address - Fax:253-589-0175
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00019181207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease