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General NPI Number Information
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NPI Number | 1538376777
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Entity Type | Individual
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Provider Name | RAJNISH MISHRA MD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 1221 MADISON ST STE 1220
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City | SEATTLE
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State | WA
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Zip | 98104-3588
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Country | US
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Telephone | 206-215-4250
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 MADISON ST STE 1220
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City | SEATTLE
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State | WA
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Zip | 98104-3588
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Country | US
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Telephone | 206-215-4250
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301096338
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301096338
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0116017320
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD60234885
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License Number State | WA
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