Provider Demographics
NPI:1033616966
Name:GILL, SUNITA KAUR (LPN)
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:KAUR
Last Name:GILL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 S SERGEANT ST
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-7520
Mailing Address - Country:US
Mailing Address - Phone:425-773-5142
Mailing Address - Fax:
Practice Address - Street 1:21851 84TH AVE S STE 101
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-1958
Practice Address - Country:US
Practice Address - Phone:425-947-2462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-08
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
WA61458941364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst