Provider Demographics
NPI:1144938200
Name:BAUVA, DRASHTEE ASHWIN
Entity type:Individual
Prefix:
First Name:DRASHTEE
Middle Name:ASHWIN
Last Name:BAUVA
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 1:12626 176TH PL NE UNIT A
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-2382
Mailing Address - Country:US
Mailing Address - Phone:909-968-3551
Mailing Address - Fax:
Practice Address - Street 1:15600 NE 8TH ST STE E6
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-4087
Practice Address - Country:US
Practice Address - Phone:425-214-7679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61359673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist