Healthcare Provider Details

I. General information

NPI: 1134700263
Provider Name (Legal Business Name): GURPINDER KAUR KHOSA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14402 E SPRAGUE AVE
SPOKANE VALLEY WA
99216-2167
US

IV. Provider business mailing address

14402 E SPRAGUE AVE
SPOKANE VALLEY WA
99216-2167
US

V. Phone/Fax

Practice location:
  • Phone: 509-922-2625
  • Fax: 877-521-3642
Mailing address:
  • Phone: 509-922-2625
  • Fax: 877-521-3642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD61511764
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: