Provider Demographics
NPI:1710189253
Name:DUGGAL, PRIYANKA (MD)
Entity Type:Individual
Prefix:DR
First Name:PRIYANKA
Middle Name:
Last Name:DUGGAL
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:PO BOX 3947
Mailing Address - Street 2:MS 315010
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-3947
Mailing Address - Country:US
Mailing Address - Phone:425-688-5670
Mailing Address - Fax:425-453-5139
Practice Address - Street 1:1750 112TH AVE NE
Practice Address - Street 2:SUITE A101
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3752
Practice Address - Country:US
Practice Address - Phone:206-598-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60091834207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0254263OtherL&I
WA1710189253Medicaid
WA0254263OtherL&I