Provider Demographics
NPI:1811310816
Name:DHRU, DHAVALKIRTI SATISHCHANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:DHAVALKIRTI
Middle Name:SATISHCHANDRA
Last Name:DHRU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DHAVAL
Other - Middle Name:S
Other - Last Name:DHRU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:426 SW 295TH PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3530
Mailing Address - Country:US
Mailing Address - Phone:253-709-9718
Mailing Address - Fax:
Practice Address - Street 1:3670 STONE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8004
Practice Address - Country:US
Practice Address - Phone:206-834-4100
Practice Address - Fax:206-834-4131
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA16534207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology