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General NPI Number Information
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NPI Number | 1578438479
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Entity Type | Organization
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Legal Business Name | DIABETES REDEFINED, LLC
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 9620 NE TANASBOURNE DR
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City | HILLSBORO
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State | OR
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Zip | 97124-7843
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Country | US
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Telephone | 844-537-8776
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Fax |
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Provider Business Mailing Address
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Address Line | 9620 NE TANASBOURNE DR
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City | HILLSBORO
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State | OR
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Zip | 97124-7843
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Country | US
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Telephone | 844-537-8776
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HARPREET NAGRA
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Credential | PHD
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Telephone | 844-537-8776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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