Basic Information
| Provider Information | |||||||||
| NPI: | 1811225923 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GHIMIRE | ||||||||
| FirstName: | GOPAL | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Credential: | MD, PHD, MRCP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 LILLY RD NE STE 100 | ||||||||
| Address2: | PROVIDENCE CARDIOLOGY ASSOCIATES | ||||||||
| City: | OLYMPIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985065195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604138525 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 500 LILLY RD NE STE 100 | ||||||||
| Address2: | PROVIDENCE CARDIOLOGY ASSOCIATES | ||||||||
| City: | OLYMPIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985065195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604138525 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2009 | ||||||||
| LastUpdateDate: | 05/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | MD60562967 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.