KISHA GAUTAMI THAYAPRAN MD
NPI 1790588457
Student in an Organized Health Care Education/Training Program in Tacoma, WA

Q: What is Kisha Thayapran's NPI number?

The NPI number for Kisha Thayapran is 1790588457. It was assigned to this individual provider in the NPPES registry on March 28, 2025.

Q: What is Kisha Thayapran's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Kisha Thayapran was last updated on March 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 28, 2025PECOS Enrolled

1717 S J ST # MS 01-125, TACOMA, WA 98405(253) 552-8690 Get Directions Write a Review

NPPES record last updated: March 28, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Kisha Gautami Thayapran Md NPPES

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

KISHA GAUTAMI THAYAPRAN MD (NPI 1790588457) is an individual student in an organized health care education/training program in Tacoma, Washington and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790588457

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameKISHA GAUTAMI THAYAPRANCredential: MD

Location Address1717 S J ST # MS 01-125Tacoma, WA 98405-4933

Mailing Address1717 S J St # Ms 01-125Tacoma, WA 98405-4933

Phone(253) 552-8690

Sole ProprietorYes

Enumeration DateMarch 28, 2025

NPPES CertifiedMarch 28, 2025

✔ NPI 1790588457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1717 S J ST # MS 01-125, Tacoma, WA 98405

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kisha Gautami Thayapran Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 15

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

MYSHELLE WILLIAMS