Healthcare Provider Details

I. General information

NPI: 1649111022
Provider Name (Legal Business Name): ANUSHKA AGRAWAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22321 19TH AVE SE
BOTHELL WA
98021-8450
US

IV. Provider business mailing address

22321 19TH AVE SE
BOTHELL WA
98021-8450
US

V. Phone/Fax

Practice location:
  • Phone: 425-533-1704
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: