Provider Demographics
NPI:1205628484
Name:KOALA PEDIATRICS PLLC
Entity type:Organization
Organization Name:KOALA PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAWALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-933-7151
Mailing Address - Street 1:8415 SE 35TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-3027
Mailing Address - Country:US
Mailing Address - Phone:650-933-7151
Mailing Address - Fax:920-214-1221
Practice Address - Street 1:14655 NE BEL RED RD STE 201
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3900
Practice Address - Country:US
Practice Address - Phone:650-933-7151
Practice Address - Fax:920-214-1221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty