Provider Demographics
NPI:1659512259
Name:HURKADLI, SAMRUDDHI (MS)
Entity Type:Individual
Prefix:
First Name:SAMRUDDHI
Middle Name:
Last Name:HURKADLI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8571 SE 72ND ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-5414
Mailing Address - Country:US
Mailing Address - Phone:425-233-4391
Mailing Address - Fax:
Practice Address - Street 1:8571 SE 72ND ST
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-5414
Practice Address - Country:US
Practice Address - Phone:425-233-4391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004053235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist