Provider Demographics
NPI:1902841448
Name:SANDHU, JOSHLENE D (OD)
Entity Type:Individual
Prefix:
First Name:JOSHLENE
Middle Name:D
Last Name:SANDHU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1837 156TH AVE NE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-4387
Mailing Address - Country:US
Mailing Address - Phone:425-643-2020
Mailing Address - Fax:253-292-2090
Practice Address - Street 1:1837 156TH AVE NE
Practice Address - Street 2:SUITE 201
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4387
Practice Address - Country:US
Practice Address - Phone:425-643-2020
Practice Address - Fax:253-292-2090
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00586100152W00000X
NYTUV6585-1152W00000X
WAOD60348374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist