Provider Demographics
NPI:1437168002
Name:KOVACS, CARLA PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:PATRICIA
Last Name:KOVACS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4011 TALBOT RD S
Mailing Address - Street 2:SUTE 430
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5773
Mailing Address - Country:US
Mailing Address - Phone:425-251-3454
Mailing Address - Fax:425-264-3201
Practice Address - Street 1:4011 TALBOT RD S
Practice Address - Street 2:SUTE 430
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5773
Practice Address - Country:US
Practice Address - Phone:425-251-3454
Practice Address - Fax:425-264-3201
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60095470207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1437168002Medicaid