Provider Demographics
NPI:1770693699
Name:SINGH, VIRTAJ (MD)
Entity type:Individual
Prefix:
First Name:VIRTAJ
Middle Name:
Last Name:SINGH
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 1:1700 WESTLAKE AVE N STE 400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-6236
Mailing Address - Country:US
Mailing Address - Phone:206-849-9130
Mailing Address - Fax:
Practice Address - Street 1:3213 EASTLAKE AVE E STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-7127
Practice Address - Country:US
Practice Address - Phone:206-861-8200
Practice Address - Fax:206-324-1178
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML20008695208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation