Provider Demographics
NPI:1780867200
Name:RAO, SUMITA (PT)
Entity Type:Individual
Prefix:
First Name:SUMITA
Middle Name:
Last Name:RAO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11695 NE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-5268
Mailing Address - Country:US
Mailing Address - Phone:425-637-1855
Mailing Address - Fax:
Practice Address - Street 1:11695 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5268
Practice Address - Country:US
Practice Address - Phone:425-637-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPT00010650OtherWA PHYSICALTHERAPY BOARD