Healthcare Provider Details
I. General information
NPI: 1861329088
Provider Name (Legal Business Name): KADLEC FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
888 SWIFT BLVD
RICHLAND WA
99352-3514
US
IV. Provider business mailing address
888 SWIFT BLVD
RICHLAND WA
99352-3514
US
V. Phone/Fax
- Phone: 509-942-2661
- Fax:
- Phone: 509-942-2661
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHUN
TAM
Title or Position: RESIDENT
Credential: MD
Phone: 509-942-2661