Individual
SHONALI RAYNEEKA PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 NE 4TH ST STE 105, RENTON, WA 98056-4100
(425) 690-3410
(425) 690-9410
Mailing address
3901 NE 4TH ST STE 105, RENTON, WA 98056-4100
(425) 690-3410
(425) 690-9410
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
AP70094616
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20175152
—
WA
Enumeration date
10/29/2024
Last updated
05/10/2026
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