Healthcare Provider Details

I. General information

NPI: 1215808894
Provider Name (Legal Business Name): ASEESS KAUR CHADHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S 19TH ST
TACOMA WA
98405-2922
US

IV. Provider business mailing address

2121 S 19TH ST
TACOMA WA
98405-2922
US

V. Phone/Fax

Practice location:
  • Phone: 253-396-1634
  • Fax: 253-396-1663
Mailing address:
  • Phone: 253-396-1634
  • Fax: 253-396-1663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCG61681213
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: