Healthcare Provider Details

I. General information

NPI: 1598184293
Provider Name (Legal Business Name): PREETHI RANGACHARI RAGHU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 03/01/2026
Certification Date: 03/01/2026
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: 509-363-7531
  • Fax:
Mailing address:
  • Phone: 509-363-7531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number63507
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA160480
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: