Healthcare Provider Details

I. General information

NPI: 1124482716
Provider Name (Legal Business Name): RAKSHA PRADHAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 W NORTH RIVER DR
SPOKANE WA
99201-3208
US

IV. Provider business mailing address

322 W NORTH RIVER DR
SPOKANE WA
99201-3208
US

V. Phone/Fax

Practice location:
  • Phone: 509-324-6464
  • Fax: 509-241-2056
Mailing address:
  • Phone: 509-324-6464
  • Fax: 509-241-2056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberOP61155870
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: