Healthcare Provider Details

I. General information

NPI: 1265605661
Provider Name (Legal Business Name): SHARONJEET KAUR SANGHA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2008
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 MADISON ST STE 1440
SEATTLE WA
98104-3538
US

IV. Provider business mailing address

1229 MADISON ST STE 1440
SEATTLE WA
98104-3538
US

V. Phone/Fax

Practice location:
  • Phone: 206-625-0578
  • Fax:
Mailing address:
  • Phone: 206-625-0578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD60291214
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA103250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: