Provider Demographics
NPI:1316229628
Name:BHARGAVA, PALLAVI (MD)
Entity type:Individual
Prefix:DR
First Name:PALLAVI
Middle Name:
Last Name:BHARGAVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 NW MYHRE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7662
Mailing Address - Country:US
Mailing Address - Phone:564-240-4080
Mailing Address - Fax:564-240-4088
Practice Address - Street 1:1950 NW MYHRE RD FL 2
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7662
Practice Address - Country:US
Practice Address - Phone:564-240-4080
Practice Address - Fax:564-240-4088
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61526161207RI0200X
MI4301074628207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2326338Medicaid