Provider Demographics
NPI:1003618281
Name:MONDOTHI, EUNICE
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:MONDOTHI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27205 33RD PL S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-7078
Mailing Address - Country:US
Mailing Address - Phone:206-889-0838
Mailing Address - Fax:253-981-3563
Practice Address - Street 1:27205 33RD PL S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-7078
Practice Address - Country:US
Practice Address - Phone:206-889-0838
Practice Address - Fax:253-981-3563
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA755713374U00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide