MEDICARE: RAMYA MEENAKSHI SUNDARAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT61493218	WA

General Provider Information

NPI Number	:	1790623643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMYA MEENAKSHI SUNDARAM

Provider Business Mailing Address
First Line	:	1650 LYNDON FARM CT STE 300
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-5005
Country	:	US
Telephone Number	:	726-202-3039
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 MAIN AVE S
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-8215
Country	:	US
Telephone Number	:	425-888-1156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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