Healthcare Provider Details

I. General information

NPI: 1669659413
Provider Name (Legal Business Name): TRI-CITY ANESTHESIA AND PAIN MANAGEMENT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 WELLSIAN WAY SUITE 102
RICHLAND WA
99352-4120
US

IV. Provider business mailing address

221 WELLSIAN WAY SUITE 102
RICHLAND WA
99352-4120
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-0900
  • Fax: 509-946-8900
Mailing address:
  • Phone: 509-946-0900
  • Fax: 509-946-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: WEI QIU
Title or Position: SOLE MEMBER
Credential: MD
Phone: 509-946-0900