Healthcare Provider Details

I. General information

NPI: 1154539088
Provider Name (Legal Business Name): EKTA KHURANA, MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 GOETHALS DR SUITE 310
RICHLAND WA
99352-3552
US

IV. Provider business mailing address

945 GOETHALS DR SUITE 310
RICHLAND WA
99352-3552
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-7332
  • Fax: 509-946-1995
Mailing address:
  • Phone: 509-946-7332
  • Fax: 509-946-1995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. EKTA KHURANA
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 509-946-7332