Basic Information
Provider Information
NPI: 1578850913
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARORA
FirstName: PALLAVI
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 50095
Address2:  
City: SEATTLE
State: WA
PostalCode: 981455095
CountryCode: US
TelephoneNumber: 2065436420
FaxNumber:  
Practice Location
Address1: 325 9TH AVE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981042420
CountryCode: US
TelephoneNumber: 2067443000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/06/2011
LastUpdateDate: 08/10/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X275178NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XMD60626533WAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
01131126/RGH05NY MEDICAID
0387992105NY MEDICAID
157885091305WA MEDICAID


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