Provider Demographics
NPI:1518096338
Name:KHABRA, VIRINDERJIT SINGH (LAC, DOAM)
Entity Type:Individual
Prefix:
First Name:VIRINDERJIT
Middle Name:SINGH
Last Name:KHABRA
Suffix:
Gender:M
Credentials:LAC, DOAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 NE 134TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-3036
Mailing Address - Country:US
Mailing Address - Phone:360-907-7467
Mailing Address - Fax:
Practice Address - Street 1:2621 NE 134TH ST STE 100
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-3036
Practice Address - Country:US
Practice Address - Phone:360-907-7467
Practice Address - Fax:360-433-9619
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00954171100000X
WAAC00002775171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist