Mystkowski, Supriya Kelkar

Mystkowski, Supriya Kelkar is an individual health care provider with primary practice located at 11521 Ne 128Th St Ste 130 , Kirkland WA 98034-4317. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as her primary health care specialty. Mystkowski, Supriya Kelkar can be contacted via phone (425) 899-4280.

Contact Information

Primary practice address
11521 Ne 128Th St Ste 130 Kirkland WA 98034-4317
Phone: (425) 899-4280
Fax: (425) 899-4294
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X MD00039430 Washington

Profile Details

NPI number 1235231929
LBN Legal business name Mystkowski, Supriya Kelkar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2006
Last updated Jan 5th, 2010 - about 15 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 1235231929 NPPES
Washington MEDICAID 8283822

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