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

Koushik Varma Sangaraju

Individual provider Rheumatology Physician · NPI 1679148043

Koushik Varma Sangaraju is a Rheumatology in Lacey, Washington. Qualified in 2020, 6 years ago. Licensed in Washington.

Years since qualifying
6
Licensed in
WA
In the registry since
2021

Practice location Address checks out

4800 College St SE
Lacey, WA 98503-4389
Phone: (360) 413-4250
Fax: (360) 412-2262
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rheumatology Physician (primary) Taxonomy 207RR0500X · Licence MD.MD.70105939 (WA)

Record details

NPI number1679148043
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 26, 2021
Last updated in NPPESJune 25, 2026
Certification dateJune 25, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyRHEUMATOLOGY
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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