Healthcare Provider Details

I. General information

NPI: 1851706295
Provider Name (Legal Business Name): NIHARIKA RATH PENINGTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S UNION AVE STE B6010
TACOMA WA
98405-1806
US

IV. Provider business mailing address

316 MARTIN LUTHER KING JR WAY STE 212
TACOMA WA
98405-4254
US

V. Phone/Fax

Practice location:
  • Phone: 253-383-5777
  • Fax:
Mailing address:
  • Phone: 253-383-5777
  • Fax: 253-403-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD60966216
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2014020169
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: