Provider Demographics
NPI:1386334209
Name:BHOSALE, KRUTIKA SHIVAJI (PT)
Entity type:Individual
Prefix:
First Name:KRUTIKA SHIVAJI
Middle Name:
Last Name:BHOSALE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22500 NE MARKETPLACE DR STE 204
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-2033
Mailing Address - Country:US
Mailing Address - Phone:425-836-1034
Mailing Address - Fax:425-836-1037
Practice Address - Street 1:22500 NE MARKETPLACE DR STE 204
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-2033
Practice Address - Country:US
Practice Address - Phone:425-836-1034
Practice Address - Fax:425-836-1037
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050210225100000X
WAPT61443213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist