PARTHA GONAVARAM (NPI# 1053473090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053473090 |
| Entity Type | Individual |
| Full Name | PARTHA GONAVARAM |
| Credential | MD |
| Practice Address |
10510 Gravelly Lake Dr Sw Lakewood WA 98499-5036 |
| Mailing Address |
1019 Pacific Ave Ste. 300 Tacoma WA 98402-4443 |
| Practice Telephone | 2535897030 |
| Practice Fax Number | 2535897033 |
| Mailing Telephone | 2537221556 |
| Mailing Fax Number | 2535974556 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2015-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD00047232 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8473399 | 05 |
| Street Address |
10510 GRAVELLY LAKE DR SW |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-5036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821086208 | Paul D Schneider | Internal Medicine | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2005-10-11 |
| 1306487863 | Danielle Nichol Kasmar | Registered Nurse | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2019-10-04 |
| 1790337384 | Bihishta Abdul Wase | Dentist | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2019-07-12 |
| 1467927152 | Caixia Lan | Dentist | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2018-10-09 |
| 1003396953 | Marisol Salazar | Physician Assistant | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2018-08-20 |
| 1689176067 | Alyssa Ann Habner | Registered Nurse | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2018-03-01 |
| 1780108126 | Charles Siler | Physician Assistant | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2017-07-27 |
| 1780117473 | Melinda Moritz | Registered Nurse | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2017-04-10 |
| 1871048355 | Gregory Robert Hudson | Nurse Practitioner | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2016-08-24 |
| 1316348154 | Dimitrios Maragakis | Dentist | 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499-5036 | 2014-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
| Find all providers in zip 98499 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1356860803 | Front Range Clinic Inc. | Family Medicine | 1410 Vance St Ste 201, Lakewood, CO 80214-5435 | 2017-09-15 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1083148324 | Stephanie Baker | Family Medicine | 255 S Routt St, Lakewood, CO 80228-2271 | 2017-04-13 |
| 1043766413 | Paladina Health, LLC | Family Medicine | 3701 Michelson St, Lakewood, CA 90712-1402 | 2016-08-26 |
| 1245686674 | Gary James Cantrell Jr. | Family Medicine | 12105 W Alameda Pkwy Ste 100, Lakewood, CO 80228-2832 | 2016-05-04 |
| 1073967394 | Mirna S Rizkalla | Family Medicine | 3650 South St Ste 404, Lakewood, CA 90712 | 2016-04-22 |
| 1194145656 | Mile High Wound and Hyperbaric Medicine Pllc | Family Medicine | 12065 W Auburn Dr, Lakewood, CO 80228-4765 | 2014-04-23 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.