Provider Demographics
NPI:1679555155
Name:NAIDU, AMEE SRIKANTH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:AMEE
Middle Name:SRIKANTH
Last Name:NAIDU
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:12910 TOTEM LAKE BLVD NE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2954
Mailing Address - Country:US
Mailing Address - Phone:425-899-3270
Mailing Address - Fax:425-899-3269
Practice Address - Street 1:11521 NE 128TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4317
Practice Address - Country:US
Practice Address - Phone:425-899-6800
Practice Address - Fax:425-899-6808
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10004635363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8439861Medicaid
WA202766OtherLABOR & INDUSTRIES