Provider Demographics
NPI:1376028936
Name:BRAR, KIRANJOT (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIRANJOT
Middle Name:
Last Name:BRAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 N 10TH PL APT 2219
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5491
Mailing Address - Country:US
Mailing Address - Phone:509-432-4966
Mailing Address - Fax:
Practice Address - Street 1:1215 N LANDING WAY
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5521
Practice Address - Country:US
Practice Address - Phone:425-207-0078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60828071183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist