Provider Demographics
NPI:1932462694
Name:NARSAI, BHAVNA
Entity Type:Individual
Prefix:
First Name:BHAVNA
Middle Name:
Last Name:NARSAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21276 SE 42ND LN
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-9514
Mailing Address - Country:US
Mailing Address - Phone:425-392-0358
Mailing Address - Fax:
Practice Address - Street 1:14215 SE PETROVITSKY RD
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-8983
Practice Address - Country:US
Practice Address - Phone:425-235-7772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000063449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist