Healthcare Provider Details

I. General information

NPI: 1619558442
Provider Name (Legal Business Name): NAVREET KAUR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6824 19TH ST W # 256
UNIVERSITY PLACE WA
98466-5528
US

IV. Provider business mailing address

6824 19TH ST W # 256
UNIVERSITY PLACE WA
98466-5528
US

V. Phone/Fax

Practice location:
  • Phone: 253-777-1423
  • Fax:
Mailing address:
  • Phone: 253-777-1423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number61338354
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95017012
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number61338354
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: