Healthcare Provider Details

I. General information

NPI: 1972735157
Provider Name (Legal Business Name): RAINIER INTERNAL MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9720 S TACOMA WAY
LAKEWOOD WA
98499-4456
US

IV. Provider business mailing address

PO BOX 39680
LAKEWOOD WA
98496-3680
US

V. Phone/Fax

Practice location:
  • Phone: 253-503-3666
  • Fax:
Mailing address:
  • Phone: 253-304-7753
  • Fax: 253-302-8493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ASIF RASHID KHAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 253-200-0300