Provider Demographics
NPI:1376790584
Name:PIYA, BIRENDRA (MD)
Entity Type:Individual
Prefix:
First Name:BIRENDRA
Middle Name:
Last Name:PIYA
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 1:1200 12TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2712
Mailing Address - Country:US
Mailing Address - Phone:206-326-2400
Mailing Address - Fax:206-621-4434
Practice Address - Street 1:1200 12TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2712
Practice Address - Country:US
Practice Address - Phone:206-326-2400
Practice Address - Fax:206-621-4434
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHFB0673815-198207Q00000X
WAMD60268913207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine