Provider Demographics
NPI:1447979893
Name:JOSHLENE D SANDHU PLLC
Entity type:Organization
Organization Name:JOSHLENE D SANDHU PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHLENE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:917-544-5801
Mailing Address - Street 1:1414 116TH AVE NE STE B
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3801
Mailing Address - Country:US
Mailing Address - Phone:917-544-5801
Mailing Address - Fax:
Practice Address - Street 1:1414 116TH AVE NE STE B
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3801
Practice Address - Country:US
Practice Address - Phone:917-544-5801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2084536Medicaid