Provider Demographics
NPI:1639986912
Name:DHANJAL, NAVITA (PA)
Entity type:Individual
Prefix:
First Name:NAVITA
Middle Name:
Last Name:DHANJAL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15446 BEL RED RD STE 450
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5507
Mailing Address - Country:US
Mailing Address - Phone:508-904-0371
Mailing Address - Fax:
Practice Address - Street 1:15446 BEL RED RD STE 450
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5507
Practice Address - Country:US
Practice Address - Phone:425-600-7478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPENDING363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant