Provider Demographics
NPI:1538376777
Name:MISHRA, RAJNISH (MD)
Entity type:Individual
Prefix:
First Name:RAJNISH
Middle Name:
Last Name:MISHRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 MADISON ST
Mailing Address - Street 2:STE 1220
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3588
Mailing Address - Country:US
Mailing Address - Phone:206-215-4250
Mailing Address - Fax:
Practice Address - Street 1:1221 MADISON ST
Practice Address - Street 2:STE 1220
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3588
Practice Address - Country:US
Practice Address - Phone:206-215-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096338207R00000X, 207RG0100X
VA0116017320390200000X
WAMD60234885207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD60234885OtherWA STATE LICENSE