Healthcare Provider Details

I. General information

NPI: 1528451085
Provider Name (Legal Business Name): FELIX RAMOS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7425 WRIGLEY DR STE 201
PASCO WA
99301
US

IV. Provider business mailing address

1060 W ELM AVE STE 115
HERMISTON OR
97838-2723
US

V. Phone/Fax

Practice location:
  • Phone: 718-901-8410
  • Fax:
Mailing address:
  • Phone: 541-289-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD10964
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDE60869990
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: