Healthcare Provider Details

I. General information

NPI: 1275912271
Provider Name (Legal Business Name): SONAL CHITNIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19401 40TH AVE SUITE 330
LYNNWOOD WA
98036
US

IV. Provider business mailing address

6900 132ND PL SE APT 5-204
NEWCASTLE WA
98059-9136
US

V. Phone/Fax

Practice location:
  • Phone: 425-670-9987
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT60122324
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: