Provider Demographics
NPI:1750392619
Name:TRYTKO, RODNEY (MD)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:
Last Name:TRYTKO
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 1:5428 S REGAL ST UNIT 30729
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-8068
Mailing Address - Country:US
Mailing Address - Phone:509-220-6808
Mailing Address - Fax:
Practice Address - Street 1:5428 S REGAL ST UNIT 30729
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-8068
Practice Address - Country:US
Practice Address - Phone:509-220-6808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2016-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA25931207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8603128Medicaid
D31056Medicare UPIN
AB05848Medicare PIN