Provider Demographics
NPI:1114564275
Name:KHAREL, PRAKASH (ARNP)
Entity type:Individual
Prefix:
First Name:PRAKASH
Middle Name:
Last Name:KHAREL
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40412
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1255
Mailing Address - Country:US
Mailing Address - Phone:866-259-1629
Mailing Address - Fax:855-666-8541
Practice Address - Street 1:606 OAKESDALE AVE SW STE C200
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5227
Practice Address - Country:US
Practice Address - Phone:866-259-1629
Practice Address - Fax:855-666-8541
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61340281363LF0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program