Provider Demographics
NPI:1679862858
Name:BANDHLISH, ANSHU (MD)
Entity Type:Individual
Prefix:
First Name:ANSHU
Middle Name:
Last Name:BANDHLISH
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 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BOX 357470
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6422
Mailing Address - Country:US
Mailing Address - Phone:206-616-9343
Mailing Address - Fax:206-543-3644
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX 357470
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6422
Practice Address - Country:US
Practice Address - Phone:206-616-9343
Practice Address - Fax:206-543-3644
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60533338207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology