Provider Demographics
NPI:1982564779
Name:MOKSHA WELLNESS THERAPY, PLLC
Entity type:Organization
Organization Name:MOKSHA WELLNESS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RDN
Authorized Official - Prefix:MS
Authorized Official - First Name:RAJNI
Authorized Official - Middle Name:SAMYUKTHA
Authorized Official - Last Name:KRISHNA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, RDN, LMHCA
Authorized Official - Phone:206-414-9636
Mailing Address - Street 1:21412 50TH AVE W UNIT 8
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-3323
Mailing Address - Country:US
Mailing Address - Phone:206-414-9636
Mailing Address - Fax:
Practice Address - Street 1:6126 NE BOTHELL WAY FL 2
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-8939
Practice Address - Country:US
Practice Address - Phone:206-414-9636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty