PRAVEEN BODAKUNTA


Address: 33480 13th Pl S, Federal Way, WA 98003-6357
Phone: 2532857101

PRAVEEN BODAKUNTA (NPI# 1295243848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295243848
Entity Type Individual
Full Name PRAVEEN BODAKUNTA
Credential PMHNP
Practice Address 33480 13th Pl S
Federal Way
WA 98003-6357
Mailing Address 9330 59th Ave Sw
Lakewood
WA 98499-2858
Practice Telephone 2532857101
Mailing Telephone 2536205015
Enumeration Date 2018-01-17
Last Update Date 2019-03-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WP0808X Registered Nurse
Specialization: Psych/Mental Health
RN60641646 WA Nursing Service Providers
N 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
A60909328 WA Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
9330 59th Ave Sw, Lakewood, WA 984992858 2536205015

Office Location

Street Address 33480 13TH PL S
City FEDERAL WAY
State WA
Zip Code 98003-6357

Providers in the same location

NPI Name Taxonomy Address Enumeration
1790298347 Telecare Mental Health Services of Washington, Inc Psychiatric Residential Treatment Facility 33480 13th Pl S, Federal Way, WA 98003-6357 2017-11-06
1871194993 Christine Karanja Counselor 33480 13th Pl S, Federal Way, WA 98003-6357 2020-11-04
1407457526 Chasity Riddle Counselor 33480 13th Pl S, Federal Way, WA 98003-6357 2020-11-04
1457969958 Nicole Mcbride Registered Nurse 33480 13th Pl S, Federal Way, WA 98003-6357 2020-07-21
1053939579 Steffi Miesha Johnson Registered Nurse 33480 13th Pl S, Federal Way, WA 98003-6357 2020-07-10
1043834047 Margie Shin Registered Nurse 33480 13th Pl S, Federal Way, WA 98003-6357 2020-06-04
1417571415 Tavon Shelley Counselor 33480 13th Pl S, Federal Way, WA 98003-6357 2020-06-04
1609490606 Cameron Rowe Counselor 33480 13th Pl S, Federal Way, WA 98003-6357 2020-06-04
1093339251 Ronald Cabanilla Licensed Practical Nurse 33480 13th Pl S, Federal Way, WA 98003-6357 2020-06-03
1477177954 Henry E Paul Counselor 33480 13th Pl S, Federal Way, WA 98003-6357 2020-06-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124634969 Jossie Jeniffer Wong-vicuna Interpreter 3001 S 288th Street, 201, Ferderal Way, WA 98003 2020-09-17
1336642420 Otto Family Massage Therapist 720 S 348th St Ste A-1b, Federal Way, WA 98003 2018-03-14
1962912709 Lindsay Plumley Occupational Therapist 33330 8th Avenue S, Federal Way, WA 98003 2017-10-06
1861922387 Sea Mar Community Health Centers Pharmacy 31405 18th Ave South, Federal Way, WA 98003 2017-06-18
1023547072 Iora Health Washington Physicians, P.C. Internal Medicine 1414 S. 324th Street, Federal Way, WA 98003 2017-06-05
1811346869 Iora Senior Health Inc Internal Medicine 1414 S 324th St, Federal Way, WA 98003 2016-06-10
1972958940 Kathy Marie Haviland Registered Nurse 1010 S. 336th St, Supplemental Health Care, Federal Way, WA 98003 2016-04-27
1972969343 Jacklyn Marie James Specialist 530 South 336th Street, Ste C, Massage for Health and Day Spa, Inc., Federal Way, WA 98003 2016-01-14
1659767036 Jillian Liner Pediatrics 34503 9th Ave S Ste 220, Federal Way, WA 98003 2015-04-12
1235537739 Simranjit Singh Longia Student in an Organized Health Care Education/Training Program 34618 11th Ave. S., Suite 100, Federal Way, WA 98003 2014-12-15
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Taxonomy Information

Taxonomy Code 163WP0808X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1346848561 Heidi Lynnette Kangas Registered Nurse 1128 Broadway St, Longview, WA 98632-3831 2020-10-09
1184235418 Afuthal Ndugwa Ssemakula Registered Nurse 614 Riverside Dr Apt B103, Wenatchee, WA 98801-6154 2020-08-11
1225671969 Virginia Hadley Registered Nurse 3436 Mary Elder Rd Ne # E&t, Olympia, WA 98506-5050 2019-10-25
1114569464 Diana Wilcox Registered Nurse 2011 Mottman Rd Sw, Tumwater, WA 98512-6218 2019-10-08
1023579430 Joan Watkins Opyr Registered Nurse Telecare North Sound E&t, 7825 North Sound Drive, Sedro-woolley, WA 98273 2019-03-28
1609351717 Charlotte Gex Morgan Registered Nurse 57 W Main St Ste 260, Chehalis, WA 98532-4815 2018-09-25
1821571050 Kimberlee Susan Long Registered Nurse 4104 Puffin Rd, Ferndale, WA 98248-9579 2018-09-13
1235669607 Bridget Lash Registered Nurse 4319 Tyler Way, Anacortes, WA 98221-3215 2017-06-18
1174072623 Vicki Boothe Registered Nurse 26254 Ne Barrett Rd, Kingston, WA 98346-9342 2016-09-26
1265981997 Lorraine Jeanette Diricco Registered Nurse 1717 W Francis Ave Ste 204, Spokane, WA 99205 2016-09-22
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Competitor

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City FEDERAL WAY
Zip Code 98003

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Dataset Information

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.

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