Healthcare Provider Details

I. General information

NPI: 1477862878
Provider Name (Legal Business Name): CAMERON RITCHIE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2010
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 SWIFT BLVD
RICHLAND WA
99352-3513
US

IV. Provider business mailing address

821 SWIFT BLVD
RICHLAND WA
99352-3513
US

V. Phone/Fax

Practice location:
  • Phone: 509-606-5040
  • Fax: 509-946-7253
Mailing address:
  • Phone: 509-606-5040
  • Fax: 509-946-7253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOA60302465
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberOA60302465
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOA60302465
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: