Provider Demographics
NPI:1003881012
Name:RASKY, ADAM LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:LOUIS
Last Name:RASKY
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 1:505 NE 87TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1989
Mailing Address - Country:US
Mailing Address - Phone:360-904-6781
Mailing Address - Fax:360-859-3173
Practice Address - Street 1:505 NE 87TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1989
Practice Address - Country:US
Practice Address - Phone:360-904-6781
Practice Address - Fax:360-859-3173
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041407207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8316127Medicaid
WA8316127Medicaid
G8910994Medicare PIN