Healthcare Provider Details

I. General information

NPI: 1962495283
Provider Name (Legal Business Name): HAROLD G PREIKSAITIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 07/08/2023
Certification Date: 07/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 S PERRY ST STE 260
SPOKANE WA
99202-3462
US

IV. Provider business mailing address

907 S PERRY ST STE 260
SPOKANE WA
99202-3462
US

V. Phone/Fax

Practice location:
  • Phone: 509-456-5433
  • Fax:
Mailing address:
  • Phone: 509-868-8816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD00042906
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: