Provider Demographics
NPI:1386092054
Name:NAGRA, AMNINDER (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:AMNINDER
Middle Name:
Last Name:NAGRA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:PROF
Other - First Name:AMNINDER
Other - Middle Name:
Other - Last Name:NAGRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD PSYCH PENDING
Mailing Address - Street 1:12614 101ST AVENUE CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98329-7225
Mailing Address - Country:US
Mailing Address - Phone:415-937-7544
Mailing Address - Fax:
Practice Address - Street 1:12614 101ST AVENUE CT NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98329-7225
Practice Address - Country:US
Practice Address - Phone:415-937-7544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV09569369103TC0700X
IL098775238207RG0100X
PA09569369390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology