Healthcare Provider Details

I. General information

NPI: 1407792898
Provider Name (Legal Business Name): PARDEEP KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9055 3RD AVE SW
SEATTLE WA
98106-3104
US

IV. Provider business mailing address

9055 3RD AVE SW
SEATTLE WA
98106-3104
US

V. Phone/Fax

Practice location:
  • Phone: 206-539-7171
  • Fax:
Mailing address:
  • Phone: 206-676-2045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP.70102435-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: