Provider Demographics
NPI:1811225923
Name:GHIMIRE, GOPAL (MD, PHD, MRCP)
Entity Type:Individual
Prefix:DR
First Name:GOPAL
Middle Name:
Last Name:GHIMIRE
Suffix:
Gender:M
Credentials:MD, PHD, MRCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LILLY RD NE STE 100
Mailing Address - Street 2:PROVIDENCE CARDIOLOGY ASSOCIATES
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5195
Mailing Address - Country:US
Mailing Address - Phone:360-413-8525
Mailing Address - Fax:
Practice Address - Street 1:500 LILLY RD NE STE 100
Practice Address - Street 2:PROVIDENCE CARDIOLOGY ASSOCIATES
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5195
Practice Address - Country:US
Practice Address - Phone:360-413-8525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60562967207RI0011X
WAMD 60562967207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology