Provider Demographics
NPI:1780818518
Name:NANDA, KABITA (MD)
Entity Type:Individual
Prefix:DR
First Name:KABITA
Middle Name:
Last Name:NANDA
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 1:4800 SAND POINT WAY NE # R-5420
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-2057
Mailing Address - Fax:206-987-5060
Practice Address - Street 1:4800 SAND POINT WAY NE # R-5420
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2057
Practice Address - Fax:206-987-5060
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0932002080P0216X
WAMD602739132080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025720450001Medicaid
OH2954727Medicaid
OHNA4267391Medicare PIN
PA1025720450001Medicaid