Provider Demographics
NPI:1588247225
Name:NAGIN, ROMA BHARAT (MD)
Entity type:Individual
Prefix:DR
First Name:ROMA
Middle Name:BHARAT
Last Name:NAGIN
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 1:861 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-5186
Mailing Address - Country:US
Mailing Address - Phone:360-371-5855
Mailing Address - Fax:360-371-5857
Practice Address - Street 1:861 GRANT AVE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230-5186
Practice Address - Country:US
Practice Address - Phone:360-371-5855
Practice Address - Fax:360-371-5857
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA61649934207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program