Provider Demographics
NPI:1750642666
Name:CHAWLA, SUTINDER KAUR
Entity Type:Individual
Prefix:
First Name:SUTINDER
Middle Name:KAUR
Last Name:CHAWLA
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 1:1531 NE 145TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7205
Mailing Address - Country:US
Mailing Address - Phone:206-366-4672
Mailing Address - Fax:206-366-4674
Practice Address - Street 1:1531 NE 145TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98155-7205
Practice Address - Country:US
Practice Address - Phone:206-366-4672
Practice Address - Fax:206-366-4674
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist