Provider Demographics
NPI:1700979069
Name:VORA, YASMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:YASMIN
Middle Name:
Last Name:VORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10020 SE 245TH PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-5129
Mailing Address - Country:US
Mailing Address - Phone:206-347-0966
Mailing Address - Fax:
Practice Address - Street 1:1300 S 320TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5359
Practice Address - Country:US
Practice Address - Phone:253-839-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045054207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMEDICAL LICENSEOtherMD 00045054
MIE58893Medicare UPIN