Individual
MR. PRACHANDA KHADKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2555 MARVIN RD NE, LACEY, WA 98516-3138
(360) 413-4200
(360) 413-4225
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP125526
TX
Other
Enumeration date
11/04/2016
Last updated
09/22/2022
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