Healthcare Provider Details

I. General information

NPI: 1114852712
Provider Name (Legal Business Name): HARNEET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2382 HETTERVIG PL
FERNDALE WA
98248-9207
US

IV. Provider business mailing address

2382 HETTERVIG PL
FERNDALE WA
98248-9207
US

V. Phone/Fax

Practice location:
  • Phone: 360-526-1889
  • Fax:
Mailing address:
  • Phone: 360-526-1889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN61211274
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: