Provider Demographics
NPI:1548644149
Name:OGLAT, AYAH (MD)
Entity type:Individual
Prefix:DR
First Name:AYAH
Middle Name:
Last Name:OGLAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AYAH
Other - Middle Name:
Other - Last Name:OGLAT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1400 E KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 S 13TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4107
Practice Address - Country:US
Practice Address - Phone:360-814-6113
Practice Address - Fax:360-814-6111
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10053920207R00000X
WAMD61367357207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine