Healthcare Provider Details

I. General information

NPI: 1871049809
Provider Name (Legal Business Name): MEGHANA SRINIVAS KINARIWALA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGHANA SRINIVAS

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 8TH AVE STE 318C
SPOKANE WA
99204-2318
US

IV. Provider business mailing address

PO BOX 421
LIBERTY LAKE WA
99019-0421
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-6650
  • Fax:
Mailing address:
  • Phone: 866-747-2455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberMD61227584
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD61227584
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: