Provider Demographics
NPI:1962495283
Name:PREIKSAITIS, HAROLD G (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:G
Last Name:PREIKSAITIS
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 1:907 S PERRY ST STE 260
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-3462
Mailing Address - Country:US
Mailing Address - Phone:509-868-8816
Mailing Address - Fax:
Practice Address - Street 1:907 S PERRY ST STE 260
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-3462
Practice Address - Country:US
Practice Address - Phone:509-456-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2023-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042906207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8367310Medicaid
WA8367310Medicaid
WAAB40081Medicare ID - Type Unspecified