Healthcare Provider Details

I. General information

NPI: 1376187104
Provider Name (Legal Business Name): KULWINDER K SEERA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 02/23/2024
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 W FRONT STREET
PORT ANGELES WA
98362-8433
US

IV. Provider business mailing address

240 W FRONT STREET
PORT ANGELES WA
98362
US

V. Phone/Fax

Practice location:
  • Phone: 360-452-7891
  • Fax: 360-452-8087
Mailing address:
  • Phone: 360-452-7891
  • Fax: 360-452-8087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61403334
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN60087680
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61403334
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: