Matta, Shakti K

Matta, Shakti K is an sole proprietor health care provider with primary practice located at 6802 W Rio Grande Ave Ste 1 , Kennewick WA 99336-7684. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Matta, Shakti K can be contacted via phone (509) 572-2201.

Contact Information

Primary practice address
6802 W Rio Grande Ave Ste 1 Kennewick WA 99336-7684
Phone: (509) 572-2201
Fax: (509) 783-8844
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD00035969 Washington

Profile Details

NPI number 1679652135
LBN Legal business name Matta, Shakti K
Credentials MBBS, DCH, MD, FAAP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 3rd, 2006
Last updated Sep 18th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679652135 NPPES
Washington Other 0124991 WA STATE DL&I #
Washington MEDICAID 8227530 WA STATE DL&I #

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