Provider Demographics
NPI:1053576710
Name:JOSEPH, SASHA OOMMEN (MD)
Entity type:Individual
Prefix:DR
First Name:SASHA
Middle Name:OOMMEN
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 S I ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5016
Mailing Address - Country:US
Mailing Address - Phone:253-428-8751
Mailing Address - Fax:
Practice Address - Street 1:34509 9TH AVE S
Practice Address - Street 2:SUITE 107
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6700
Practice Address - Country:US
Practice Address - Phone:253-952-8349
Practice Address - Fax:253-927-3049
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603839​25207RH0000X, 207RX0202X
PAMD436651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP01363078OtherRAILROAD MEDICARE
WA2030233Medicaid
WA2030233Medicaid