Provider Demographics
NPI:1639126238
Name:RIGGS, RANDALL STUART (MD)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:STUART
Last Name:RIGGS
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 1:611 E 2ND AVE
Mailing Address - Street 2:STE C
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-6010
Mailing Address - Country:US
Mailing Address - Phone:509-534-5000
Mailing Address - Fax:509-534-0288
Practice Address - Street 1:611 E 2ND AVE
Practice Address - Street 2:STE C
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-6010
Practice Address - Country:US
Practice Address - Phone:509-534-5000
Practice Address - Fax:509-534-0288
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000141802084P0800X, 207ZP0102X
WAMD000014180207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1048982Medicaid
WAAB32999OtherMEDICARE GROUP
WA1048982Medicaid
WAAB32999OtherMEDICARE GROUP
WAG8859854Medicare PIN