Provider Demographics
NPI:1316107501
Name:SHARMA, VASUDHA (RPT)
Entity type:Individual
Prefix:MRS
First Name:VASUDHA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 204TH ST SW
Mailing Address - Street 2:C-102
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6893
Mailing Address - Country:US
Mailing Address - Phone:310-986-4280
Mailing Address - Fax:
Practice Address - Street 1:2717 DEXTER AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1914
Practice Address - Country:US
Practice Address - Phone:206-284-7012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00010715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist