Provider Demographics
NPI:1184307217
Name:SHELDON, TONDRA L
Entity type:Individual
Prefix:
First Name:TONDRA
Middle Name:L
Last Name:SHELDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 1ST AVE N STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4765
Mailing Address - Country:US
Mailing Address - Phone:206-859-5030
Mailing Address - Fax:206-859-5031
Practice Address - Street 1:415 1ST AVE N STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4765
Practice Address - Country:US
Practice Address - Phone:206-859-5030
Practice Address - Fax:206-859-5031
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC00001256224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant