Provider Demographics
NPI:1811204894
Name:SANDHU, HARPAL AMARJEET SINGH (MD)
Entity type:Individual
Prefix:
First Name:HARPAL
Middle Name:AMARJEET SINGH
Last Name:SANDHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HARPAL
Other - Middle Name:S
Other - Last Name:HARPAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4225 NE ST JAMES RD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-2148
Mailing Address - Country:US
Mailing Address - Phone:503-274-2121
Mailing Address - Fax:866-654-7990
Practice Address - Street 1:5440 SW WESTGATE DR STE 217
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221-2421
Practice Address - Country:US
Practice Address - Phone:503-274-2121
Practice Address - Fax:866-843-7765
Is Sole Proprietor?:No
Enumeration Date:2010-09-11
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61056751207W00000X, 207WX0107X
KY49620207W00000X
ORMD198777207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK211600Medicare PIN