1629157011 NPI number — GURINDER P SAHI MD PS

Table of content: (NPI 1629157011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629157011 NPI number — GURINDER P SAHI MD PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GURINDER P SAHI MD PS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EVERGREEN INTERNISTS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629157011
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15127 NE 24TH ST
Provider Second Line Business Mailing Address:
PMB 510
Provider Business Mailing Address City Name:
REDMOND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98052-5544
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-825-3900
Provider Business Mailing Address Fax Number:
425-821-2549

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2217 152ND AVE NE STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDMOND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98052-5519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-825-3900
Provider Business Practice Location Address Fax Number:
425-821-2549
Provider Enumeration Date:
11/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SAHI
Authorized Official First Name:
GURINDER
Authorized Official Middle Name:
P
Authorized Official Title or Position:
CHAIRMAN
Authorized Official Telephone Number:
425-825-3900

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  602 621 198 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)