Healthcare Provider Details

I. General information

NPI: 1841754926
Provider Name (Legal Business Name): SHARANYA CHAVVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 214TH ST SE STE 300
BOTHELL WA
98021-4418
US

IV. Provider business mailing address

225 BROADWAY UNIT 648
SEATTLE WA
98122-6656
US

V. Phone/Fax

Practice location:
  • Phone: 425-412-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.70041477
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: