Provider Demographics
NPI:1326184409
Name:MACHTLEY, SOUNDUS (PT, DPT, OCS, MTC)
Entity Type:Individual
Prefix:DR
First Name:SOUNDUS
Middle Name:
Last Name:MACHTLEY
Suffix:
Gender:F
Credentials:PT, DPT, OCS, MTC
Other - Prefix:MS
Other - First Name:SOUNDUS
Other - Middle Name:
Other - Last Name:TARAZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, MTC
Mailing Address - Street 1:2319 N 45TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6982
Mailing Address - Country:US
Mailing Address - Phone:206-910-9590
Mailing Address - Fax:
Practice Address - Street 1:2319 N 45TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6982
Practice Address - Country:US
Practice Address - Phone:206-910-9590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000103612251X0800X
WAPT10361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA50-6570Medicare ID - Type UnspecifiedMEDICARE