Basic Information
| Provider Information | |||||||||
| NPI: | 1124106679 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMGOTRA | ||||||||
| FirstName: | INDERJEET | ||||||||
| MiddleName: | KAUR | ||||||||
| NamePrefix: | |||||||||
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| Credential: | EAMP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3130 E MADISON ST | ||||||||
| Address2: | #200 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981124264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063283058 | ||||||||
| FaxNumber: | 3603520637 | ||||||||
| Practice Location | |||||||||
| Address1: | 3130 E MADISON ST | ||||||||
| Address2: | #200 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981124264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063283058 | ||||||||
| FaxNumber: | 4258697691 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 04/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | MD000019469 | WA | N | Other Service Providers | Acupuncturist | 171100000X | 0001848 | WA | Y | Other Service Providers | Acupuncturist |
No ID Information.