Provider Demographics
NPI:1902090061
Name:PHARAON, KHALED RASHAD (MD)
Entity type:Individual
Prefix:DR
First Name:KHALED
Middle Name:RASHAD
Last Name:PHARAON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:505 NE 87TH AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1989
Mailing Address - Country:US
Mailing Address - Phone:360-514-1854
Mailing Address - Fax:360-514-6063
Practice Address - Street 1:505 NE 87TH AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1989
Practice Address - Country:US
Practice Address - Phone:360-514-1854
Practice Address - Fax:360-514-6063
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2013-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD603650232086S0102X, 2086S0127X
ORMD1567402086S0127X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care