Individual
RIDHIMA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
240 DIVISION ST, GRANDVIEW, WA 98930-1357
(509) 882-4700
(509) 882-6088
Mailing address
240 DIVISION ST, GRANDVIEW, WA 98930-1357
(509) 882-4700
(509) 882-6088
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD60579723
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730476292
—
WA
01
—
G8944869
MEDICARE PTAN
WA
01
—
G8944870
MEDICARE PTAN
WA
Enumeration date
07/06/2011
Last updated
03/18/2021
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