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NPI Code Detail

MEDICARE: MR. DALE RASCHKO PA

MEDICARE: MR. DALE RASCHKO PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1497089056
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DALE RASCHKO PA
Provider Business Mailing Address
First Line : 105 W 8TH AVE
Second Line : SUITE 6080
City : SPOKANE
State : WA
Zip : 99204-2313
Country : US
Telephone Number : 509-838-6500
Fax Number : 509-838-6561
Provider Business Practice Location Address
First Line : 105 W 8TH AVE
Second Line : SUITE 6080
City : SPOKANE
State : WA
Zip : 99204-2313
Country : US
Telephone Number : 509-838-6500
Fax Number : 509-838-6561
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2009
Last Update Date : 09/29/2009

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Directions to “ MR. DALE RASCHKO PA” Practice Location

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