Healthcare Provider Details

I. General information

NPI: 1184699977
Provider Name (Legal Business Name): RITU PABBY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12615 E MISSION AVE STE 300
SPOKANE VALLEY WA
99216-1047
US

IV. Provider business mailing address

12615 E MISSION AVE STE 300
SPOKANE VALLEY WA
99216-1047
US

V. Phone/Fax

Practice location:
  • Phone: 509-960-5520
  • Fax: 509-255-7792
Mailing address:
  • Phone: 509-960-5520
  • Fax: 509-255-7792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number0101244890
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number5714
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD60623801
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: