Individual
JEFFREY RADAKOVICH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
NE 1125 WASHINGTON ST, WASHINGTON STATE UNIVERSITY, PULLMAN, WA 99164-0001
(509) 335-3575
Mailing address
PO BOX 642302, PULLMAN, WA 99164-2302
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00036670
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8233975
—
WA
Enumeration date
02/09/2006
Last updated
07/08/2007
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