Provider Demographics
NPI:1114121274
Name:RANCHOD, SURESH (DO)
Entity Type:Individual
Prefix:DR
First Name:SURESH
Middle Name:
Last Name:RANCHOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1942 WESTLAKE AVE
Mailing Address - Street 2:#2502
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1208
Mailing Address - Country:US
Mailing Address - Phone:206-860-4329
Mailing Address - Fax:
Practice Address - Street 1:600 BROADWAY
Practice Address - Street 2:SUITE 270
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122
Practice Address - Country:US
Practice Address - Phone:206-860-4329
Practice Address - Fax:206-215-2289
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor