Provider Demographics
NPI:1588308811
Name:KHATRA, RUBI (RN61080029)
Entity type:Individual
Prefix:
First Name:RUBI
Middle Name:
Last Name:KHATRA
Suffix:
Gender:F
Credentials:RN61080029
Other - Prefix:
Other - First Name:RUBI
Other - Middle Name:
Other - Last Name:CHAHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29606 120TH CT SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-3271
Mailing Address - Country:US
Mailing Address - Phone:206-321-0690
Mailing Address - Fax:
Practice Address - Street 1:29606 120TH CT SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-3271
Practice Address - Country:US
Practice Address - Phone:206-321-0690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61080029163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health