Healthcare Provider Details

I. General information

NPI: 1851022909
Provider Name (Legal Business Name): HARINI USHASRI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N 13TH ST
SHELTON WA
98584-2077
US

IV. Provider business mailing address

1701 N 13TH ST
SHELTON WA
98584-2077
US

V. Phone/Fax

Practice location:
  • Phone: 360-426-2653
  • Fax:
Mailing address:
  • Phone: 360-426-2653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD70041896
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: