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General NPI Number Information
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NPI Number | 1992123707
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Entity Type | Individual
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Provider Name | HARJOT K THIND-DEOL MD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 24900 SE STARK ST STE 202
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City | GRESHAM
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State | OR
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Zip | 97030-3382
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Country | US
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Telephone | 502-944-6300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 78534
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City | MILWAUKEE
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State | WI
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Zip | 53278-8534
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Country | US
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Telephone | 815-398-9491
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Fax | 815-381-7498
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 036-155990
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License Number State | IL
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