Provider Demographics
NPI:1528368420
Name:TIKOO, PRAGATI (MD)
Entity Type:Individual
Prefix:
First Name:PRAGATI
Middle Name:
Last Name:TIKOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11913 NE 195TH ST
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3147
Mailing Address - Country:US
Mailing Address - Phone:425-489-3100
Mailing Address - Fax:425-489-3183
Practice Address - Street 1:11913 NE 195TH ST
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3147
Practice Address - Country:US
Practice Address - Phone:425-489-3100
Practice Address - Fax:425-489-3183
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA247135207R00000X
WA60701866207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine