Healthcare Provider Details

I. General information

NPI: 1356246391
Provider Name (Legal Business Name): CONQUER PHYSICAL THERAPY, WELLNESS & PERFORMANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7981 168TH AVE NE STE 106
REDMOND WA
98052-0911
US

IV. Provider business mailing address

7981 168TH AVE NE STE 106
REDMOND WA
98052-0911
US

V. Phone/Fax

Practice location:
  • Phone: 425-645-5976
  • Fax:
Mailing address:
  • Phone: 425-645-5976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: SUJAYA DEODHAR
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 347-226-1467