Healthcare Provider Details

I. General information

NPI: 1760008270
Provider Name (Legal Business Name): ALDORA INJURY AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2020
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7631 212TH ST SW STE 107B
EDMONDS WA
98026-7565
US

IV. Provider business mailing address

4580 KLAHANIE DR SE # 197
SAMMAMISH WA
98029-5812
US

V. Phone/Fax

Practice location:
  • Phone: 425-610-9394
  • Fax: 833-418-1959
Mailing address:
  • Phone: 425-610-9394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: VIVAKSHA KHANDURI
Title or Position: ARNP
Credential: DNP, FNP-BC
Phone: 425-610-9394