Provider Demographics
NPI:1659424661
Name:SINGH, KULJEET (OD)
Entity Type:Individual
Prefix:DR
First Name:KULJEET
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31625 PACIFIC HWY S STE E1
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5645
Mailing Address - Country:US
Mailing Address - Phone:253-946-4392
Mailing Address - Fax:
Practice Address - Street 1:31625 PACIFIC HWY S STE E1
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5645
Practice Address - Country:US
Practice Address - Phone:253-946-4392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003824152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0642SIOtherREGENCE PIN
WAWA 0979 SIOtherNBN PIN
WAWA 3824OtherEYEMED PIN