Healthcare Provider Details

I. General information

NPI: 1053231423
Provider Name (Legal Business Name): CARLOS SAUCEDO RAMIREZ PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 W KENNEWICK AVE
KENNEWICK WA
99336-2921
US

IV. Provider business mailing address

3121 W KENNEWICK AVE
KENNEWICK WA
99336-2921
US

V. Phone/Fax

Practice location:
  • Phone: 509-735-7433
  • Fax: 509-735-6577
Mailing address:
  • Phone: 509-735-7433
  • Fax: 509-735-6577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: