Basic Information
Provider Information
NPI: 1003804659
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARAND
FirstName: GLORIA
MiddleName: A.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 12TH AVE S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981442712
CountryCode: US
TelephoneNumber: 2063262400
FaxNumber:  
Practice Location
Address1: 1200 12TH AVE S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981442712
CountryCode: US
TelephoneNumber: 2063262400
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/07/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XMD00038859WAY Allopathic & Osteopathic PhysiciansPediatrics 

ID Information
IDTypeStateIssuerDescription
826306305WA MEDICAID


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