Provider Demographics
NPI:1265518062
Name:VENKATESH, NIPALI A (MD)
Entity type:Individual
Prefix:
First Name:NIPALI
Middle Name:A
Last Name:VENKATESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIPALI
Other - Middle Name:A
Other - Last Name:BHARANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6400 SOUTHCENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2547
Mailing Address - Country:US
Mailing Address - Phone:206-901-2000
Mailing Address - Fax:
Practice Address - Street 1:13555 NE BEL RED RD STE 228
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2324
Practice Address - Country:US
Practice Address - Phone:206-901-2000
Practice Address - Fax:206-901-2000
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000421512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8396111Medicaid
WAP00167233OtherRAIL ROAD MEDICARE
262810OtherINTERNAL ID-MOTOR VEHICLE ID
I07911Medicare UPIN
WAP00167233OtherRAIL ROAD MEDICARE
WAG8804179Medicare PIN