Healthcare Provider Details

I. General information

NPI: 1497089056
Provider Name (Legal Business Name): DALE RASCHKO PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2009
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12410 E SINTO AVE STE 101
SPOKANE VALLEY WA
99216-2258
US

IV. Provider business mailing address

12410 E SINTO AVE STE 101
SPOKANE VALLEY WA
99216-2258
US

V. Phone/Fax

Practice location:
  • Phone: 509-789-2955
  • Fax: 509-789-2975
Mailing address:
  • Phone: 509-789-2975
  • Fax: 509-789-2975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: