Provider Demographics
NPI:1477645133
Name:MERCHANT, ROHINTON K (MD)
Entity Type:Individual
Prefix:
First Name:ROHINTON
Middle Name:K
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RON
Other - Middle Name:
Other - Last Name:MERCHANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:909 N BROADWAY
Mailing Address - Street 2:PBO
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1409
Mailing Address - Country:US
Mailing Address - Phone:425-258-7357
Mailing Address - Fax:425-258-7022
Practice Address - Street 1:916 PACIFIC AVE
Practice Address - Street 2:1 SOUTH
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4147
Practice Address - Country:US
Practice Address - Phone:425-258-7390
Practice Address - Fax:425-258-7379
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020956207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1033042Medicaid
WAE28601Medicare UPIN
WAG8877562Medicare PIN
WAAB24022Medicare ID - Type Unspecified