Provider Demographics
NPI:1316261670
Name:SHRESTHA, RIJESH RAJ (MD)
Entity type:Individual
Prefix:DR
First Name:RIJESH
Middle Name:RAJ
Last Name:SHRESTHA
Suffix:
Gender:
Credentials:MD
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 66657
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98166-0657
Mailing Address - Country:US
Mailing Address - Phone:253-444-3320
Mailing Address - Fax:
Practice Address - Street 1:815 S VASSAULT ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465-2008
Practice Address - Country:US
Practice Address - Phone:253-444-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60906627207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2141417Medicaid
PA175629Medicare PIN