Healthcare Provider Details

I. General information

NPI: 1982279758
Provider Name (Legal Business Name): RUBINDER KOUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 AUBURN WAY N
AUBURN WA
98002-4148
US

IV. Provider business mailing address

1231 AUBURN WAY N
AUBURN WA
98002-4148
US

V. Phone/Fax

Practice location:
  • Phone: 253-939-5355
  • Fax:
Mailing address:
  • Phone: 253-939-5355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberVA60179496
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: