Healthcare Provider Details

I. General information

NPI: 1497012496
Provider Name (Legal Business Name): VRAJESH PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RAJ PATEL MD

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE STE N
SPOKANE WA
99201-0581
US

IV. Provider business mailing address

522 W RIVERSIDE AVE STE N
SPOKANE WA
99201-0581
US

V. Phone/Fax

Practice location:
  • Phone: 509-355-4983
  • Fax: 509-246-6727
Mailing address:
  • Phone: 509-355-4983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number60654661
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: