Basic Information
Provider Information
NPI: 1609805761
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BATRA
FirstName: MANBIR
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 9TH AVE
Address2: MS M4-PA
City: SEATTLE
State: WA
PostalCode: 981012756
CountryCode: US
TelephoneNumber: 2065836025
FaxNumber: 2065155886
Practice Location
Address1: 1100 9TH AVE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981012756
CountryCode: US
TelephoneNumber: 2062236600
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/01/2006
LastUpdateDate: 12/31/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD00016330WAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
US086140101WAAETNA/USHC SPECIALISTOTHER
827000105WA MEDICAID
MD330WA01WAALASKA MEDICAIDOTHER
80425150001WAIDAHO MEDICAIDOTHER
003951501WALABOR & INDUSTRYOTHER
B16801WABLUE SHIELDOTHER
160980576101WAMONTANA DSHSOTHER
5003155901 RAILROAD MEDICAREOTHER


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