Provider Demographics
NPI:1255969796
Name:SHARMA, CHANDNI (DO)
Entity type:Individual
Prefix:
First Name:CHANDNI
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 102809
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91189-2809
Mailing Address - Country:US
Mailing Address - Phone:235-697-1420
Mailing Address - Fax:253-697-1439
Practice Address - Street 1:1322 3RD ST SE
Practice Address - Street 2:#300
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372
Practice Address - Country:US
Practice Address - Phone:253-697-1420
Practice Address - Fax:253-697-1439
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program