Provider Demographics
NPI:1518542067
Name:DHILLON, JAGJIT KAUR
Entity Type:Individual
Prefix:MRS
First Name:JAGJIT
Middle Name:KAUR
Last Name:DHILLON
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 1:292 EDMONDS AVE SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-8848
Mailing Address - Country:US
Mailing Address - Phone:206-355-1311
Mailing Address - Fax:
Practice Address - Street 1:292 EDMONDS AVE SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-8848
Practice Address - Country:US
Practice Address - Phone:206-355-1311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA4732171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter