Healthcare Provider Details

I. General information

NPI: 1992772685
Provider Name (Legal Business Name): NORTHWEST ORTHOPAEDIC ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 SWIFT BLVD
RICHLAND WA
99352-3592
US

IV. Provider business mailing address

875 SWIFT BLVD
RICHLAND WA
99352-3592
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-1654
  • Fax: 509-943-5652
Mailing address:
  • Phone: 509-946-1654
  • Fax: 509-943-5652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRI HIGGINS
Title or Position: FINANCIAL MANAGER
Credential:
Phone: 509-946-1654