Healthcare Provider Details

I. General information

NPI: 1003143652
Provider Name (Legal Business Name): WILLIAM FORSYTHE, DO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8656 W GAGE BLVD STE A106
KENNEWICK WA
99336-1150
US

IV. Provider business mailing address

8656 W GAGE BLVD STE A106
KENNEWICK WA
99336-1150
US

V. Phone/Fax

Practice location:
  • Phone: 509-366-2108
  • Fax:
Mailing address:
  • Phone: 509-366-2108
  • Fax: 217-355-8347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM CHARLES FORSYTHE
Title or Position: OWNER
Credential: DO
Phone: 509-460-1065