Healthcare Provider Details

I. General information

NPI: 1508128539
Provider Name (Legal Business Name): ZENIA KAUR BRAR MA, MHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2012
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 NE OAK VIEW DR SUITE B
VANCOUVER WA
98662-6157
US

IV. Provider business mailing address

13107 NW 33RD AVE
VANCOUVER WA
98685-2287
US

V. Phone/Fax

Practice location:
  • Phone: 360-567-2211
  • Fax:
Mailing address:
  • Phone: 360-573-8663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG60200894
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: