Healthcare Provider Details
I. General information
NPI: 1033597737
Provider Name (Legal Business Name): WRIGHT SURGICAL ARTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2015
Last Update Date: 03/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5908 BEDFORD ST STE C
PASCO WA
99301-6605
US
IV. Provider business mailing address
303 BRADLEY BLVD STE 206
RICHLAND WA
99352-4497
US
V. Phone/Fax
- Phone: 509-792-1404
- Fax: 509-792-1405
- Phone: 509-943-8842
- Fax: 509-943-8851
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JASON
DAVID
WRIGHT
Title or Position: MEDICAL DIRECTOR
Credential: D,O,
Phone: 509-792-1404