Provider Demographics
NPI:1376799403
Name:SASTRY, SNEHA (MD)
Entity Type:Individual
Prefix:
First Name:SNEHA
Middle Name:
Last Name:SASTRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 E GREEN LAKE WAY N STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5491
Mailing Address - Country:US
Mailing Address - Phone:206-524-5656
Mailing Address - Fax:206-524-2841
Practice Address - Street 1:6800 E GREEN LAKE WAY N STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5491
Practice Address - Country:US
Practice Address - Phone:206-524-5656
Practice Address - Fax:206-524-2841
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD605917532084P0800X, 2084P0804X
MI43010950542084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry