Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | OP60097497 | WA |
Y | 111NI0900X | Internist | OP60097497 | WA |
N | 207RA0401X | Internist - Addiction Medicine | OP60097497 | WA |
NPI | 1366648222 |
---|---|
Provider Name | Dr. Ajainder Shergill |
First Address | Danville, CA 94506-1189 |
Second Address | University Place, WA 98466-4724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 11/08/2020 |