Basic Information
| Provider Information | |||||||||
| NPI: | 1588862924 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEOL | ||||||||
| FirstName: | GUR RAJ | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 519 S. PEABODY | ||||||||
| Address2: | STE 3 | ||||||||
| City: | PORT ANGELES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605659237 | ||||||||
| FaxNumber: | 3605829241 | ||||||||
| Practice Location | |||||||||
| Address1: | 2980 SQUALICUM PKWY STE 301 | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982251880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607886112 | ||||||||
| FaxNumber: | 3607886114 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2007 | ||||||||
| LastUpdateDate: | 07/30/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | MD60138552 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | MD60138552 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.