Healthcare Provider Details

I. General information

NPI: 1861787384
Provider Name (Legal Business Name): GRAHAM WORDSWORTH OSBORN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1979 SNYDER ST STE 150
RICHLAND WA
99354-5321
US

IV. Provider business mailing address

1979 SNYDER ST STE 150
RICHLAND WA
99354-5321
US

V. Phone/Fax

Practice location:
  • Phone: 509-376-3333
  • Fax:
Mailing address:
  • Phone: 509-376-6853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number61282494
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: