Provider Demographics
NPI:1669232625
Name:SIVAKUMAR, BEENA
Entity type:Individual
Prefix:MRS
First Name:BEENA
Middle Name:
Last Name:SIVAKUMAR
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 1:1959 NE PACIFIC STREET, BOX 356365
Mailing Address - Street 2:ROOM B440
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-3635
Mailing Address - Country:US
Mailing Address - Phone:203-543-0903
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC STREET,
Practice Address - Street 2:ROOM B440
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-3635
Practice Address - Country:US
Practice Address - Phone:203-543-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program