Renato Verano Fajardo, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

30962 Issued in WA

Practice address

34616 11TH PL S
#3
Federal Way, WA 98003-8705

Phone

(253) 874-5148

Fax

(253) 874-4228

NPI assigned

Sep 9, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397174400000",
    "number": "1760476352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34616 11TH PL S STE 3",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038705",
            "telephone_number": "253-874-5148",
            "fax_number": "253-874-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34616 11TH PL S",
            "address_2": "#3",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038705",
            "telephone_number": "253-874-5148",
            "fax_number": "253-874-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "RENATO",
        "middle_name": "VERANO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2014-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "30962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LI",
            "identifier": "124708",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mariya I Fair, RN
• Fairview Lane Afh LLC
• Faith and Hope General Agencies
• Faith Rwams Afh LLC
• Patricia M Falsetto, CDP,LMHC
• Family and Wellness Medicine
• Family Medicine Clinic of Federal Way
• Family Vision Care, Inc.
• Victoria B Fang, MD

• Internal Medicine Physician in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.