Healthcare Provider Details

I. General information

NPI: 1760310213
Provider Name (Legal Business Name): SADHISHAAN SREEDHARAN MBBS, FRACS (PLAST)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE M/S OB 9.520
SEATTLE WA
98105
US

IV. Provider business mailing address

PO BOX 5371 M/S OB 9.523
SEATTLE WA
98145-5005
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-1032
  • Fax:
Mailing address:
  • Phone: 447-498-5116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMDFE.FE.70088634
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMDFE.FE.70088634
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: