=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164364394
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ISHA RAJVANSHI
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2026
-----------------------------------------------------
Last Update Date | 04/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 932 49TH PL SW
-----------------------------------------------------
City | EVERETT
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98203-1750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-884-4578
-----------------------------------------------------
Fax | 888-718-4696
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 932 49TH PL SW
-----------------------------------------------------
City | EVERETT
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98203-1750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-884-4578
-----------------------------------------------------
Fax | 888-718-4696
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MHCA.MC.70040983
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------