Provider Demographics
NPI:1982337978
Name:VAZA, SHIVANI (MD)
Entity type:Individual
Prefix:
First Name:SHIVANI
Middle Name:
Last Name:VAZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHIVANI
Other - Middle Name:
Other - Last Name:VAZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1801 NW MARKET ST STE 207
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3909
Mailing Address - Country:US
Mailing Address - Phone:206-386-2550
Mailing Address - Fax:
Practice Address - Street 1:1801 NW MARKET ST STE 207
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3909
Practice Address - Country:US
Practice Address - Phone:063-862-5502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9493207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine