MARANATHA MEDICAL CLINIC INC P S
NPI 1205164639
Internal Medicine in Renton, WA

Active since November 23, 2009
17900 TALBOT RD S, #101, RENTON, WA 98055(425) 235-9614(425) 235-1060 Get Directions Write a Review

NPPES record last updated: September 11, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 11, 2017, Aug 30, 2017 (2 updates tracked since 2017).

About Maranatha Medical Clinic Inc P S NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARANATHA MEDICAL CLINIC INC P S (NPI 1205164639) is a healthcare organization registered as an internal medicine in Renton, Washington and active in the NPI registry since November 2009. The organization lists Dan L Grav Es, President, as its authorized official.

NPPES Registry Identity

NPI1205164639
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMARANATHA MEDICAL CLINIC INC P S
Location Address17900 TALBOT RD S, #101Renton, WA 98055-8212
Mailing Address17900 Talbot Rd S, #101Renton, WA 98055-8212 · (425) 235-9614 · Fax (425) 235-1060
Fax(425) 235-1060
Organization SubpartNo
Authorized OfficialDan L Grav EsPresident · (425) 235-9614
Enumeration DateNovember 23, 2009
Last NPPES UpdateSeptember 11, 20172 updates tracked since enumeration
NPI 1205164639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in WA · 17917
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

17900 TALBOT RD S, Renton, WA 98055

Other Identifiers 1

Medicaid1620509WA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
17900 TALBOT RD S, #102
RENTON, WA 98055
Family Medicine
17900 TALBOT RD S, #102
RENTON, WA 98055
Psychologist
17900 TALBOT RD S, SUITE 102
RENTON, WA 98055
Clinic/Center (Primary Care)
17900 TALBOT RD S, SUITE 101
RENTON, WA 98055
Dentist (General Practice)
17900 TALBOT RD S, SUITE 103
RENTON, WA 98055
Legal Medicine
17900 TALBOT RD S, #101
RENTON, WA 98055
Clinic/Center
17900 TALBOT RD S, #101
RENTON, WA 98055
Physician Assistant
17900 TALBOT RD S, SUITE 101
RENTON, WA 98055

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maranatha Medical Clinic Inc P S's NPI number?

The NPI number for Maranatha Medical Clinic Inc P S is 1205164639. It was assigned to this organization in the NPPES registry on November 23, 2009.

Where is Maranatha Medical Clinic Inc P S located?

Maranatha Medical Clinic Inc P S is located at 17900 Talbot Rd S #101, Renton, WA 98055. The listed phone number is (425) 235-9614.

What is Maranatha Medical Clinic Inc P S's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Maranatha Medical Clinic Inc P S was last updated on September 11, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.