| Radiant Path Psychiatry Pllc | |
|
330 King St Ste 5 Wenatchee WA 98801-2857 | |
| (509) 797-7493 | |
| (833) 913-2345 |
| Full Name | Radiant Path Psychiatry Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 330 King St Ste 5, Wenatchee, Washington |
| Authorized Official Name and Position | Raul Alexander Padilla (CEO) |
| Authorized Official Contact | 5097977493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant Path Psychiatry Pllc 330 King St Ste 5 Wenatchee WA 98801-2857 Ph: () - | Radiant Path Psychiatry Pllc 330 King St Ste 5 Wenatchee WA 98801-2857 Ph: (509) 797-7493 |
| NPI Number | 1225666951 |
|---|---|
| Provider Enumeration Date | 03/30/2020 |
| Last Update Date | 10/14/2024 |
| Certification Date | 10/14/2024 |
| Medicare PECOS PAC ID | 7911324967 |
|---|---|
| Medicare Enrollment ID | O20200904001325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225666951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Raul A Padilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932481124 PECOS PAC ID: 6608043518 Enrollment ID: I20150713001926 |
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