Provider Demographics
NPI:1013222827
Name:WADHWA, SHOBHNA (MS)
Entity Type:Individual
Prefix:
First Name:SHOBHNA
Middle Name:
Last Name:WADHWA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SHOBHNA
Other - Middle Name:
Other - Last Name:HENDRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2806 131ST ST SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6750
Mailing Address - Country:US
Mailing Address - Phone:425-443-5896
Mailing Address - Fax:425-338-2835
Practice Address - Street 1:2806 131ST ST SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6750
Practice Address - Country:US
Practice Address - Phone:425-443-5896
Practice Address - Fax:425-338-2835
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007537101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor