Provider Demographics
NPI:1689859688
Name:DASGUPTA, ROMILA (MED)
Entity Type:Individual
Prefix:
First Name:ROMILA
Middle Name:
Last Name:DASGUPTA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2895 PAULING AVE # B223
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2833
Mailing Address - Country:US
Mailing Address - Phone:512-971-4617
Mailing Address - Fax:
Practice Address - Street 1:5709 W SUNSET HWY STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-6005
Practice Address - Country:US
Practice Address - Phone:509-328-2740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist