Healthcare Provider Details

I. General information

NPI: 1265360275
Provider Name (Legal Business Name): YUVRAJ SHERGILL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 SE 8TH AVE
HILLSBORO OR
97123-4218
US

IV. Provider business mailing address

1848 SEVILLA DR
ROSEVILLE CA
95747-5061
US

V. Phone/Fax

Practice location:
  • Phone: 206-880-0336
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPI-0014847
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: