Healthcare Provider Details

I. General information

NPI: 1902498371
Provider Name (Legal Business Name): TRI-CITIES SEXUAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2021
Last Update Date: 02/08/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 KEENE RD
RICHLAND WA
99352-8683
US

IV. Provider business mailing address

138 KEENE RD
RICHLAND WA
99352-8683
US

V. Phone/Fax

Practice location:
  • Phone: 509-628-8866
  • Fax:
Mailing address:
  • Phone: 509-628-8866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL BAHNMILLER
Title or Position: OWNER
Credential: DO
Phone: 509-628-8866