Provider Demographics
NPI:1801277983
Name:SRIDHARAN, GEETHA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:GEETHA
Middle Name:
Last Name:SRIDHARAN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2908
Mailing Address - Country:US
Mailing Address - Phone:425-277-1311
Mailing Address - Fax:
Practice Address - Street 1:16255 NE 87TH ST STE 150
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7464
Practice Address - Country:US
Practice Address - Phone:425-882-1697
Practice Address - Fax:425-885-4179
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125067440208000000X, 208000000X
WA60875351208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics