Provider Demographics
NPI:1801961750
Name:KHURANA, RAHUL (MD)
Entity type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:
Last Name:KHURANA
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:PO BOX 84316
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-5616
Mailing Address - Country:US
Mailing Address - Phone:920-550-1893
Mailing Address - Fax:206-899-1545
Practice Address - Street 1:901 BOREN AVE
Practice Address - Street 2:SUITE 701
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3508
Practice Address - Country:US
Practice Address - Phone:920-550-1893
Practice Address - Fax:206-899-1545
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD0000462712084P0800X
WAMD000462712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID10153372OtherREGENCE BLUE SHIELD
WA80731038Medicaid
IDHPW68OtherBLUE CROSS OF IDAHO IND
WA7046543Medicaid
ID807310300Medicaid
IDI04667Medicare UPIN