Provider Demographics
NPI:1043386493
Name:SUNDBY, RANDI MARIT (MSPT)
Entity Type:Individual
Prefix:MS
First Name:RANDI
Middle Name:MARIT
Last Name:SUNDBY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9518 ROOSEVELT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2234
Mailing Address - Country:US
Mailing Address - Phone:206-524-1058
Mailing Address - Fax:206-524-1059
Practice Address - Street 1:9518 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2234
Practice Address - Country:US
Practice Address - Phone:206-524-1058
Practice Address - Fax:206-524-1059
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist