Provider Demographics
NPI:1184647711
Name:DARDAS, TODD FREDERICK (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:FREDERICK
Last Name:DARDAS
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 1:1959 NE PACIFIC ST BOX 356422
Mailing Address - Street 2:SUITE AA522
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6422
Mailing Address - Country:US
Mailing Address - Phone:206-543-2914
Mailing Address - Fax:206-616-4847
Practice Address - Street 1:1959 NE PACIFIC ST BOX 356422
Practice Address - Street 2:SUITE AA522
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6422
Practice Address - Country:US
Practice Address - Phone:206-543-2914
Practice Address - Fax:206-616-4847
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60152846207RA0001X
WA60152846207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1184647711Medicaid