Healthcare Provider Details

I. General information

NPI: 1316107501
Provider Name (Legal Business Name): VASUDHA SHARMA R.P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2717 DEXTER AVE N
SEATTLE WA
98109-1914
US

IV. Provider business mailing address

3730 204TH ST SW C-102
LYNNWOOD WA
98036-6893
US

V. Phone/Fax

Practice location:
  • Phone: 206-284-7012
  • Fax:
Mailing address:
  • Phone: 310-986-4280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number00010715
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: