Provider Demographics
NPI:1649574005
Name:BOGGAVARAPU, KARUNA KIRTI (OD)
Entity Type:Individual
Prefix:
First Name:KARUNA
Middle Name:KIRTI
Last Name:BOGGAVARAPU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DR KARUNA
Other - Middle Name:
Other - Last Name:SHARMA OD PLLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:22833 BOTHELL EVERETT HWY
Mailing Address - Street 2:SUITE 154
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-9385
Mailing Address - Country:US
Mailing Address - Phone:425-485-0430
Mailing Address - Fax:425-483-6198
Practice Address - Street 1:22833 BOTHELL EVERETT HWY
Practice Address - Street 2:SUITE 154
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9385
Practice Address - Country:US
Practice Address - Phone:425-485-0430
Practice Address - Fax:425-483-6198
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60150861152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8925670Medicare PIN