Provider Demographics
NPI:1376723809
Name:THAKUR, SUNAYNA (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:SUNAYNA
Middle Name:
Last Name:THAKUR
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:SUNAYNA
Other - Middle Name:
Other - Last Name:AGRAWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4325 252ND PLACE SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029
Mailing Address - Country:US
Mailing Address - Phone:425-835-2674
Mailing Address - Fax:562-694-6875
Practice Address - Street 1:4325 252ND PL SE
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:CA
Practice Address - Zip Code:98029
Practice Address - Country:US
Practice Address - Phone:425-835-2674
Practice Address - Fax:562-694-6875
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 6974225XP0200X
WAOT60433022225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics