Provider Demographics
NPI:1780141564
Name:SINGH, WASSAN (DNP)
Entity type:Individual
Prefix:
First Name:WASSAN
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2103
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-0460
Mailing Address - Country:US
Mailing Address - Phone:253-320-0748
Mailing Address - Fax:877-682-9319
Practice Address - Street 1:1313 FRYAR AVE UNIT 2103
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-1905
Practice Address - Country:US
Practice Address - Phone:253-320-0748
Practice Address - Fax:877-682-9319
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60942910363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health