Provider Demographics
NPI:1093126047
Name:VIJAYASIMHA, SUMATI
Entity Type:Individual
Prefix:
First Name:SUMATI
Middle Name:
Last Name:VIJAYASIMHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6232 S 251ST ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-2249
Mailing Address - Country:US
Mailing Address - Phone:425-522-2692
Mailing Address - Fax:
Practice Address - Street 1:6232 S 251ST ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-2249
Practice Address - Country:US
Practice Address - Phone:425-522-2692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula