Provider Demographics
NPI:1023541000
Name:RALL, KATTRINA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:KATTRINA
Middle Name:MICHELLE
Last Name:RALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATTRINA
Other - Middle Name:MICHELLE
Other - Last Name:CROUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:624 E FRONT AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2139
Mailing Address - Country:US
Mailing Address - Phone:509-626-9900
Mailing Address - Fax:509-626-9920
Practice Address - Street 1:624 E FRONT AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2139
Practice Address - Country:US
Practice Address - Phone:509-626-9900
Practice Address - Fax:509-626-9920
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61072063207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine