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General NPI Number Information
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NPI Number | 1356126460
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Entity Type | Organization
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Legal Business Name | SITA SHANKAR LLC
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 16343 NE 50TH ST
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City | REDMOND
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State | WA
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Zip | 98052-5295
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Country | US
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Telephone | 425-736-8316
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Fax |
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Provider Business Mailing Address
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Address Line | 16343 NE 50TH ST
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City | REDMOND
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State | WA
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Zip | 98052-5295
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Country | US
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Telephone | 425-736-8316
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SITA PATTABHIRAMAN SHANKAR
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Credential | MS, CCC-SLP
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Telephone | 425-736-8316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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