Healthcare Provider Details

I. General information

NPI: 1215020144
Provider Name (Legal Business Name): TRI-CITY ORTHOPAEDIC CLINIC, P S C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/14/2025
Certification Date: 09/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6703 W RIO GRANDE AVE
KENNEWICK WA
99336-2623
US

IV. Provider business mailing address

6703 W RIO GRANDE AVE
KENNEWICK WA
99336-2623
US

V. Phone/Fax

Practice location:
  • Phone: 509-460-5588
  • Fax: 509-783-5438
Mailing address:
  • Phone: 509-460-5588
  • Fax: 509-783-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberOP60232831
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberOP60220440
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberMD60261135
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateWA

VIII. Authorized Official

Name: ZACHARY LITKE
Title or Position: COO
Credential:
Phone: 509-460-5588