Healthcare Provider Details

I. General information

NPI: 1144457243
Provider Name (Legal Business Name): SHEETAL PRAMOD DHOKE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 TOTEM BEACH RD
TULALIP WA
98271-6160
US

IV. Provider business mailing address

7520 TOTEM BEACH RD
TULALIP WA
98271-6160
US

V. Phone/Fax

Practice location:
  • Phone: 360-716-4511
  • Fax:
Mailing address:
  • Phone: 360-716-4383
  • Fax: 360-716-0754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD2021-0843
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number60755875
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: