Provider Demographics
NPI:1124106679
Name:RAMGOTRA, INDERJEET KAUR (EAMP)
Entity type:Individual
Prefix:
First Name:INDERJEET
Middle Name:KAUR
Last Name:RAMGOTRA
Suffix:
Gender:F
Credentials:EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 E MADISON ST
Mailing Address - Street 2:#200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4264
Mailing Address - Country:US
Mailing Address - Phone:206-328-3058
Mailing Address - Fax:360-352-0637
Practice Address - Street 1:3130 E MADISON ST
Practice Address - Street 2:#200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4264
Practice Address - Country:US
Practice Address - Phone:206-328-3058
Practice Address - Fax:425-869-7691
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000019469171100000X
WA0001848171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist