Healthcare Provider Details

I. General information

NPI: 1912155524
Provider Name (Legal Business Name): JOSE FERNANDO ECHAIZ ARROYO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 SWIFT BLVD
RICHLAND WA
99352
US

IV. Provider business mailing address

560 GAGE BLVD SUITE 203
RICHLAND WA
99352
US

V. Phone/Fax

Practice location:
  • Phone: 509-942-2360
  • Fax: 509-942-2239
Mailing address:
  • Phone: 509-942-3627
  • Fax: 509-942-2268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301092002
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number60323861
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD60323861
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: