Healthcare Provider Details

I. General information

NPI: 1063336808
Provider Name (Legal Business Name): SUKHVIR WALIA DNP ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 OAKESDALE AVE SW STE 102
RENTON WA
98057-5204
US

IV. Provider business mailing address

604 OAKESDALE AVE SW STE 102
RENTON WA
98057-5204
US

V. Phone/Fax

Practice location:
  • Phone: 425-406-5458
  • Fax:
Mailing address:
  • Phone: 425-406-5458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number70166834
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: