Provider Demographics
NPI:1467024893
Name:KANG, YASHPREET
Entity Type:Individual
Prefix:
First Name:YASHPREET
Middle Name:
Last Name:KANG
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 1:2601 SHATTUCK CT S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5020
Mailing Address - Country:US
Mailing Address - Phone:206-393-2214
Mailing Address - Fax:425-291-7386
Practice Address - Street 1:2601 SHATTUCK CT S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5020
Practice Address - Country:US
Practice Address - Phone:206-393-2214
Practice Address - Fax:425-291-7386
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA755070374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA854319525Medicaid