Provider Demographics
NPI:1417525734
Name:RAMDEV, MANISHA (NP-C)
Entity type:Individual
Prefix:
First Name:MANISHA
Middle Name:
Last Name:RAMDEV
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23753 76TH AVE W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8807
Mailing Address - Country:US
Mailing Address - Phone:206-618-4692
Mailing Address - Fax:
Practice Address - Street 1:14040 NE 181ST ST STE 1000
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-4373
Practice Address - Country:US
Practice Address - Phone:425-483-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAF05210666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily