Ravilla L Mahidhar (NPI# 1134346836, PAC ID# 1254424815) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL CARDIOLOGY.
| Nation Provider ID (NPI) | 1134346836 |
| PAC ID by PECOS | 1254424815 |
| Professional Enrollment ID | I20120814000391 |
| Full Name | Ravilla L Mahidhar |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES-WA |
| Address |
1330 Rockefeller Ave Suite 225 Everett WA 98201-1676 |
| Phone Number | 4253165180 |
| Gender | M |
| Medical School | MARION SIMS COLLEGE OF MEDICINE - NLG |
| Graduation Year | 1998 |
| Primary Specialty | INTERVENTIONAL CARDIOLOGY |
| Group Practice PAC ID | 8325100480 |
| Number of Group Practice Members | 363 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500014 | PROVIDENCE REGIONAL MEDICAL CENTER EVERETT |
| Address | Phone | Organization |
|---|---|---|
| 1330 Rockefeller Ave, Suite 225, Everett, WA 98201-1676 | 4253165180 | PROVIDENCE HEALTH AND SERVICES-WA |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES-WA |
| Physicians | 421 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tasneem Abbas Shikary | Otolaryngology | Providence Health and Services-wa | 1330 Rockefeller Ave, Suite 230, Everett, WA 98201-1676 |
| Nicole Kraker | Nurse Practitioner | Providence Health and Services-wa | 10200 Mukilteo Speedway, Mukilteo, WA 98275-4743 |
| Crystal L Blankinship | Clinical Social Worker | Providence Health and Services-wa | 1830 Bickford Ave, Suite 211, Snohomish, WA 98290-1751 |
| Lorena Barajas | Nurse Practitioner | Providence Health and Services-wa | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 |
| Kim Quy V Nguyen | Nurse Practitioner | Providence Health and Services-wa | 19200 N Kelsey St, Monroe, WA 98272-1431 |
| Marianna Baghdasaryan | Nurse Practitioner | Providence Health and Services-wa | 13110 Bothell Everett Hwy, Everett, WA 98208-7202 |
| Tina Malm | Physician Assistant | Providence Health and Services-wa | 1321 Colby Ave, Everett, WA 98201-1665 |
| David Keisho Su | Neurosurgery | Providence Health and Services-wa | 1717 13th St, Suite 401, Everett, WA 98201-1621 |
| David B Shanholtzer | Nurse Practitioner | Providence Health and Services-wa | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 |
| Laura Knapp Knapp | Clinical Social Worker | Providence Health and Services-wa | 1509 California St, Everett, WA 98201-3540 |
| Street Address |
1330 ROCKEFELLER AVE SUITE 225 |
| City | EVERETT |
| State | WA |
| Zip | 98201-1676 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tasneem Abbas Shikary | Otolaryngology | Providence Health and Services-wa | 1330 Rockefeller Ave, Suite 230, Everett, WA 98201-1676 |
| Raynald H Im | Family Medicine | Providence Health and Services-wa | 1330 Rockefeller Ave, Everett, WA 98201-1676 |
| Cynthia A Ramsey | Nurse Practitioner | Providence Health and Services-wa | 1330 Rockefeller Ave, Everett, WA 98201-1676 |
| Evan Cantini | Physical Medicine and Rehabilitation | Providence Health and Services-wa | 1330 Rockefeller Ave, Suite 220, Everett, WA 98201-1678 |
| Nancy Churchill Lowell | Registered Dietitian Or Nutrition Professional | Providence Health and Services-wa | 1330 Rockefeller Ave, Everett, WA 98201-1676 |
| Paula D Ruedebusch | Nurse Practitioner | Providence Health and Services-wa | 1330 Rockefeller Ave, Everett, WA 98201-1676 |
| Vikram M Gopal | Psychiatry | Providence Health and Services-wa | 1330 Rockefeller Ave, Everett, WA 98201-1676 |
| Carl Jessob Gannon | Nurse Practitioner | Providence Health and Services-wa | 1330 Rockefeller Ave, Everett, WA 98201-1676 |
| Julie E Furlan | Ophthalmology | The Everett Clinic Pllc | 1330 Rockefeller Ave, Everett, WA 98201-1684 |
| Irene Altmann | Internal Medicine | The Everett Clinic Pllc | 1330 Rockefeller Ave, Everett, WA 98201-1684 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Margaret J Rutherford | Nurse Practitioner | Sunrise Services, Inc. | 1021 N Broadway, Sunrise Community Mental Health, Everett, WA 98201-1405 |
| Kevin M Knack Jr. | Nurse Practitioner | Sunrise Services, Inc. | 1021 N Broadway, Sunrise Community Mental Health, Everett, WA 98201-1405 |
| Larry S Bornstein | Psychiatry | Sunrise Services, Inc. | 1021 N Broadway, Sunrise Community Mental Health, Everett, WA 98201-1405 |
| Paulette K Carter | Nurse Practitioner | Sunrise Services, Inc. | 1021 N Broadway, Sunrise Community Mental Health, Everett, WA 98201-1405 |
| Margaret M Ackerman | Nurse Practitioner | Sunrise Services, Inc. | 1021 N Broadway, Sunrise Community Mental Health, Everett, WA 98201-1405 |
| Nikki L Behner | Nurse Practitioner | Sunrise Services, Inc. | 1021 N Broadway, Sunrise Community Mental Health, Everett, WA 98201-1405 |
| David Gordon | Family Medicine | Community Health Center of Snohomish County | 930 N Broadway, Everett, WA 98201-1409 |
| Yuanzhi Angela Li | Family Medicine | Community Health Center of Snohomish County | 930 N Broadway, Everett, WA 98201-1409 |
| Alan O Haakenstad | Nephrology | Community Health Center of Snohomish County | 930 N Broadway, Everett, WA 98201-1409 |
| Lavonne M Searle | Nurse Practitioner | Community Health Center of Snohomish County | 930 N Broadway, Everett, WA 98201-1409 |
| Find all physicians in zip 98201 | |||
| City | EVERETT |
| Zip Code | 98201 |
| Specialty | INTERVENTIONAL CARDIOLOGY |
| City + Specialty | EVERETT + INTERVENTIONAL CARDIOLOGY |
Please comment or provide details below to improve the information on Ravilla L Mahidhar.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.