Healthcare Provider Details

I. General information

NPI: 1396903944
Provider Name (Legal Business Name): LAARNI GUTIERREZ DARVIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8108 W GRANDRIDGE BLVD
RICHAND WA
99352
US

IV. Provider business mailing address

800 SWIFT BLVD SUITE 300
RICHLAND WA
99352
US

V. Phone/Fax

Practice location:
  • Phone: 509-942-3264
  • Fax: 509-735-5382
Mailing address:
  • Phone: 509-942-3627
  • Fax: 509-942-2268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA98770
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00048930
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: