Individual
GAURI SHIRISH KHANDEKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS, MS, PT
Contact information
Practice address
4122 FACTORIA BLVD SE STE 401, BELLEVUE, WA 98006-5259
(425) 562-1920
(425) 562-0054
Mailing address
4122 FACTORIA BLVD SE STE 401, BELLEVUE, WA 98006-5259
(425) 562-1920
(425) 562-0054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501012776
MI
2251X0800X
Orthopedic Physical Therapist
070015621
IL
2251X0800X
Orthopedic Physical Therapist
Primary
PT60047288
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N72320
MEDICARE GROUP #
MI
01
—
650F410180
BLUE CARE NETWORK
MI
Enumeration date
06/01/2006
Last updated
05/21/2009
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