Basic Information
| Provider Information | |||||||||
| NPI: | 1831538867 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEKA | ||||||||
| FirstName: | PRIYA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3360 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972083360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8667472455 | ||||||||
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| Practice Location | |||||||||
| Address1: | 900 PACIFIC AVE STE 501 | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982014189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252587550 | ||||||||
| FaxNumber: | 4252587450 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2013 | ||||||||
| LastUpdateDate: | 09/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD61089161 | WA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 18236 | NH | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.