Provider Demographics
NPI:1669636320
Name:AGARWAL, VANJUL (MD)
Entity Type:Individual
Prefix:DR
First Name:VANJUL
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 HOLTON AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3239
Mailing Address - Country:US
Mailing Address - Phone:509-575-7653
Mailing Address - Fax:
Practice Address - Street 1:200 NE MOTHER JOSEPH PL STE 330
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3288
Practice Address - Country:US
Practice Address - Phone:360-514-2990
Practice Address - Fax:360-514-3508
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60429543207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine