Individual
JASAN KHANGURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 491-9480
Mailing address
8260 155TH AVE SE, NEWCASTLE, WA 98059-9279
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH61296502
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH61296502
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
09/13/2022
Last updated
09/13/2022
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