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General NPI Number Information
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NPI Number | 1386092054
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Entity Type | Individual
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Provider Name | AMNINDER NAGRA M.D, PHD
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Gender | Female
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 01/05/2025
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Provider Practice Location Address
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Address Line | 12614 101ST AVENUE CT NW
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City | GIG HARBOR
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State | WA
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Zip | 98329-7225
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Country | US
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Telephone | 415-937-7544
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Fax |
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Provider Business Mailing Address
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Address Line | 12614 101ST AVENUE CT NW
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City | GIG HARBOR
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State | WA
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Zip | 98329-7225
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Country | US
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Telephone | 415-937-7544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 09569369
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 098775238
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 09569369
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License Number State | PA
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