Healthcare Provider Details

I. General information

NPI: 1437923810
Provider Name (Legal Business Name): RANJEET KAUR SEERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 N 5TH AVE
SEQUIM WA
98382-3045
US

IV. Provider business mailing address

918 JOSHUA ST
PORT ANGELES WA
98363-1456
US

V. Phone/Fax

Practice location:
  • Phone: 360-683-5900
  • Fax:
Mailing address:
  • Phone: 360-988-3704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2023165406
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: