Provider Demographics
NPI:1982133104
Name:DEOL, UPDESH KAUR (PHARMD)
Entity Type:Individual
Prefix:
First Name:UPDESH
Middle Name:KAUR
Last Name:DEOL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15707 NE 134TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-1739
Mailing Address - Country:US
Mailing Address - Phone:847-346-6960
Mailing Address - Fax:
Practice Address - Street 1:15707 NE 134TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1739
Practice Address - Country:US
Practice Address - Phone:847-346-6960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60323643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist