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Individual

DR. PONRAT PAKPREO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
16528 E DESMET CT STE B-1000, SPOKANE VALLEY, WA 99216-3522
(509) 944-8860
(509) 944-8856
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 893-8140

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
224294
NY
208000000X
Pediatrics Physician
MD00047151
WA
2080A0000X
Pediatric Adolescent Medicine Physician
224294
NY
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD00047151
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02689641
NY
05
8468340
WA
01
AB32999
MEDICARE GROUP
WA
Enumeration date
06/12/2006
Last updated
01/13/2023
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