Provider Demographics
NPI:1740495563
Name:DHATRIKA, AMITA V (MD)
Entity type:Individual
Prefix:
First Name:AMITA
Middle Name:V
Last Name:DHATRIKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:550 GAGE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9532
Mailing Address - Country:US
Mailing Address - Phone:971-358-2390
Mailing Address - Fax:509-627-2983
Practice Address - Street 1:510 N COLORADO ST STE A
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7845
Practice Address - Country:US
Practice Address - Phone:509-942-6020
Practice Address - Fax:509-942-6049
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2021-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT185293207Q00000X
WAMD611901122083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine