Healthcare Provider Details

I. General information

NPI: 1265139166
Provider Name (Legal Business Name): MRS. RAJWANT KLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2023
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33613 39TH AVE S
FEDERAL WAY WA
98001-9565
US

IV. Provider business mailing address

33613 39TH AVE S
FEDERAL WAY WA
98001-9565
US

V. Phone/Fax

Practice location:
  • Phone: 209-470-7774
  • Fax:
Mailing address:
  • Phone: 209-470-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61405824
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61405824
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: