Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Maranatha Medical Clinic Inc P S

Organization Internal Medicine Physician · NPI 1205164639

Maranatha Medical Clinic Inc P S is an Internal Medicine Physician in Renton, Washington. Licensed in Washington. Registered with an NPI since 2009.

Licensed in
WA
In the registry since
2009
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

17900 Talbot Rd S #101
Renton, WA 98055-8212
Phone: (425) 235-9614
Fax: (425) 235-1060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 17917 (WA)

Record details

NPI number1205164639
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dan Grav Es — President · (425) 235-9614
NPI enumeratedNovember 23, 2009
Last updated in NPPESSeptember 11, 2017
Mailing address17900 Talbot Rd S, 101, Renton, WA 98055-8212

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