Individual
DR. MIRANDA MCINTYRE RAICHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
529 JASMINE ST, OMAK, WA 98841-9589
(509) 826-1600
(509) 826-3633
Mailing address
817 COMMERCIAL ST, LEAVENWORTH, WA 98826-1316
(509) 548-3431
(509) 548-2510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00046640
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0211040
L&I
WA
05
—
8457434
—
WA
Enumeration date
06/28/2006
Last updated
07/06/2017
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