Provider Demographics
NPI:1811155773
Name:BHAT, RAGHURAM B (MD)
Entity type:Individual
Prefix:DR
First Name:RAGHURAM
Middle Name:B
Last Name:BHAT
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 1:2005 SE 192ND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7475
Mailing Address - Country:US
Mailing Address - Phone:360-440-1828
Mailing Address - Fax:217-636-4073
Practice Address - Street 1:2005 SE 192ND AVE STE 200
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7475
Practice Address - Country:US
Practice Address - Phone:360-440-1828
Practice Address - Fax:217-636-4073
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD606443532084P0805X, 2084P0800X, 2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine