Provider Demographics
NPI:1801355995
Name:YELGAR, SHRISHYLA (OD)
Entity type:Individual
Prefix:DR
First Name:SHRISHYLA
Middle Name:
Last Name:YELGAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19400 108TH AVE SE STE 202
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-0108
Mailing Address - Country:US
Mailing Address - Phone:253-852-2120
Mailing Address - Fax:253-373-0201
Practice Address - Street 1:19400 108TH AVE SE STE 202
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-0108
Practice Address - Country:US
Practice Address - Phone:253-852-2120
Practice Address - Fax:253-373-0201
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00882152W00000X
WA61426806152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist