Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Maranatha Medical Clinic Inc P S

Organization Internal Medicine Physician · NPI 1205164639

Maranatha Medical Clinic Inc P S provides Internal Medicine Physician services 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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