Provider Demographics
| NPI: | 1831185966 |
|---|---|
| Name: | MOHAI, PETER (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | PETER |
| Middle Name: | |
| Last Name: | MOHAI |
| 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: | PO BOX 3489 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SEATTLE |
| Mailing Address - State: | WA |
| Mailing Address - Zip Code: | 98114-3489 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 206-386-9500 |
| Mailing Address - Fax: | 206-386-9605 |
| Practice Address - Street 1: | 1229 MADISON ST STE 1450 |
| Practice Address - Street 2: | |
| Practice Address - City: | SEATTLE |
| Practice Address - State: | WA |
| Practice Address - Zip Code: | 98104-3538 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 206-844-6001 |
| Practice Address - Fax: | 062-844-6002 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2005-09-23 |
| Last Update Date: | 2024-12-16 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| WA | MD00015425 | 207RR0500X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| WA | 5891740001 | Other | DME |
| WA | 1616002 | Medicaid | |
| WA | 760113330 | Other | PALMETTO RR MEDICARE |
| WA | 78934 | Other | LABOR & INDUSTRY |
| WA | MO8931 | Other | REGENCE |
| WA | MO8931 | Other | REGENCE |
| WA | 5891740001 | Other | DME |