Provider Demographics
NPI:1003432022
Name:KAUR KHEHRA, RAJBIR
Entity Type:Individual
Prefix:DR
First Name:RAJBIR
Middle Name:
Last Name:KAUR KHEHRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 CORDATA PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8059
Mailing Address - Country:US
Mailing Address - Phone:360-676-8663
Mailing Address - Fax:360-676-8682
Practice Address - Street 1:4540 CORDATA PKWY STE 103
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8059
Practice Address - Country:US
Practice Address - Phone:360-676-8663
Practice Address - Fax:360-676-8682
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004221A152W00000X
WAOD61379154152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist