Healthcare Provider Details

I. General information

NPI: 1861768343
Provider Name (Legal Business Name): OKSANA PRYCHYNA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 07/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S STEVENS ST
SPOKANE WA
99204-2654
US

IV. Provider business mailing address

801 S STEVENS ST
SPOKANE WA
99204-2654
US

V. Phone/Fax

Practice location:
  • Phone: 509-363-7788
  • Fax: 509-363-7064
Mailing address:
  • Phone: 509-363-7788
  • Fax: 509-363-7064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD60843268
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: