Provider Demographics
NPI:1841383767
Name:MADHURI KANDALA, M.D.
Entity Type:Organization
Organization Name:MADHURI KANDALA, M.D.
Other - Org Name:WASHINGTON NEPHROLOGY AND HYPERTENSION PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SELF OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MADHURI
Authorized Official - Middle Name:
Authorized Official - Last Name:KANDALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-453-8406
Mailing Address - Street 1:2015 116TH AVE NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3018
Mailing Address - Country:US
Mailing Address - Phone:206-592-5000
Mailing Address - Fax:206-824-9510
Practice Address - Street 1:2015 116TH AVENUE NE
Practice Address - Street 2:SUITE B
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:425-453-8406
Practice Address - Fax:425-453-4173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1123520Medicaid
WA1123520Medicaid
WAG8864126Medicare PIN