Healthcare Provider Details
I. General information
NPI: 1093644973
Provider Name (Legal Business Name): DR DRYWAHL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11812 SHORELINE CT
PASCO WA
99301-9094
US
IV. Provider business mailing address
11812 SHORELINE CT
PASCO WA
99301-9094
US
V. Phone/Fax
- Phone: 509-308-9844
- Fax:
- Phone: 509-308-9844
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MELVIN
MERLE
WAHL
JR.
Title or Position: OWNER
Credential: MD
Phone: 509-308-9844