Provider Demographics
NPI:1477965507
Name:SHRESTHA, ISHA (MD)
Entity Type:Individual
Prefix:
First Name:ISHA
Middle Name:
Last Name:SHRESTHA
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 1:12800 BOTHELL EVERETT HWY STE 250
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6644
Mailing Address - Country:US
Mailing Address - Phone:425-316-5440
Mailing Address - Fax:
Practice Address - Street 1:12800 BOTHELL EVERETT HWY STE 250
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6644
Practice Address - Country:US
Practice Address - Phone:425-316-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61091458207RE0101X
CAA145244207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty