Provider Demographics
NPI:1235305293
Name:DHANDA, DEVENDER S (RPH)
Entity type:Individual
Prefix:MR
First Name:DEVENDER
Middle Name:S
Last Name:DHANDA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15021 SE 177TH PL
Mailing Address - Street 2:APT. 11-J
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9074
Mailing Address - Country:US
Mailing Address - Phone:402-203-0542
Mailing Address - Fax:
Practice Address - Street 1:3116 NE SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-3337
Practice Address - Country:US
Practice Address - Phone:425-793-5143
Practice Address - Fax:425-793-5329
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00064456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist