Provider Demographics
NPI:1801256862
Name:KOLHATKAR, SHWETA
Entity type:Individual
Prefix:
First Name:SHWETA
Middle Name:
Last Name:KOLHATKAR
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 1:13353 BEL RED RD
Mailing Address - Street 2:#103
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2329
Mailing Address - Country:US
Mailing Address - Phone:425-679-5996
Mailing Address - Fax:
Practice Address - Street 1:13353 BEL RED RD
Practice Address - Street 2:#103
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2329
Practice Address - Country:US
Practice Address - Phone:425-679-5996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60285884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist