Healthcare Provider Details

I. General information

NPI: 1265284939
Provider Name (Legal Business Name): HIMANI SUNIL DEO PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 SW 160TH ST STE 105
BURIEN WA
98166-3003
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 206-513-2155
  • Fax: 425-968-1454
Mailing address:
  • Phone: 813-560-8157
  • Fax: 812-590-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT61521916
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: