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Contact Information

KALYAN DANDALA, MD PLLC
350 S 38TH CT STE 100
RENTON, WA98055-5777
 Phone: 714-828-1800
 Fax: 714-882-1186
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
 

Adult Health

363LA2200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for KALYAN DANDALA, MD PLLC

NPI Number 1558600650
LBN Legal business name KALYAN DANDALA, MD PLLC
Authorized official MAGDALEN GUSTILO - (DIRECTOR OF PAYER RELATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 02/08/2013
Last updated 05/08/2023 - About 3 years ago
Identifiers
WA License # AP30007637
WA License # MD00048010
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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