Provider Demographics
NPI:1508395013
Name:DESAI, AMEETA M
Entity Type:Individual
Prefix:
First Name:AMEETA
Middle Name:M
Last Name:DESAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMEETA
Other - Middle Name:M
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24204 SE 14TH CT
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-8154
Mailing Address - Country:US
Mailing Address - Phone:425-677-8391
Mailing Address - Fax:
Practice Address - Street 1:24204 SE 14TH CT
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075
Practice Address - Country:US
Practice Address - Phone:425-677-8391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist