Provider Demographics
NPI:1023630951
Name:MADATHANAPALLI, KRISHNASAI ABHISHEK (MD)
Entity type:Individual
Prefix:
First Name:KRISHNASAI ABHISHEK
Middle Name:
Last Name:MADATHANAPALLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 NW MYHRE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7662
Mailing Address - Country:US
Mailing Address - Phone:564-240-4155
Mailing Address - Fax:564-240-4177
Practice Address - Street 1:1950 NW MYHRE RD FL 2
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7662
Practice Address - Country:US
Practice Address - Phone:564-240-4155
Practice Address - Fax:564-240-4177
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61592315207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology