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General NPI Number Information
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NPI Number | 1417809963
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Entity Type | Individual
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Provider Name | POONAM KALSI
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Gender | Female
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 1106 9TH AVE NE
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City | EPHRATA
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State | WA
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Zip | 98823-9026
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Country | US
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Telephone | 509-475-5646
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Fax |
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Provider Business Mailing Address
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Address Line | 330 10TH AVE SW
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City | EPHRATA
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State | WA
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Zip | 98823-2065
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Country | US
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Telephone | 509-475-5646
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Fax | 509-214-7696
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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 | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 758470
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License Number State | WA
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