Healthcare Provider Details

I. General information

NPI: 1811179864
Provider Name (Legal Business Name): RICHARD EDWARD VROMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2007
Last Update Date: 12/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N 54TH AVE
YAKIMA WA
98908-3147
US

IV. Provider business mailing address

101 N 54TH AVE
YAKIMA WA
98908-3147
US

V. Phone/Fax

Practice location:
  • Phone: 509-961-9066
  • Fax: 509-966-5518
Mailing address:
  • Phone: 509-961-9066
  • Fax: 509-966-5518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: