Healthcare Provider Details

I. General information

NPI: 1932453461
Provider Name (Legal Business Name): SHARNJIT GIRN WALIA O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2012
Last Update Date: 11/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31625 PACIFIC HWY S
FEDERAL WAY WA
98003-5645
US

IV. Provider business mailing address

1301 1ST AVE SUITE 1301
SEATTLE WA
98101-2074
US

V. Phone/Fax

Practice location:
  • Phone: 253-946-4387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number60274047
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: