Provider Demographics
NPI:1790878361
Name:KAPUR, RAJ P (MD)
Entity Type:Individual
Prefix:
First Name:RAJ
Middle Name:P
Last Name:KAPUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6829 27TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7140
Mailing Address - Country:US
Mailing Address - Phone:206-363-3881
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
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:206-987-2103
Practice Address - Fax:206-987-3840
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027741207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0037167Medicaid
WA8117335Medicaid
AKMD7741WMedicaid
ID806007800Medicaid
ID806007800Medicaid
WA8117335Medicaid