Provider Demographics
NPI:1386039550
Name:BHATIA, SEAN VIKRAM (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:VIKRAM
Last Name:BHATIA
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 1:14406 NE 20TH AVE OFC
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-1448
Mailing Address - Country:US
Mailing Address - Phone:360-571-3005
Mailing Address - Fax:360-571-3010
Practice Address - Street 1:KAISER SALMON CREEK
Practice Address - Street 2:14406 NE 20TH AVE
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686
Practice Address - Country:US
Practice Address - Phone:360-571-3005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR187602207R00000X
WA60840393207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine