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General NPI Number Information
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NPI Number | 1073409488
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Entity Type | Organization
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Legal Business Name | KENNEWICK PAIN CLINIC INC PS
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 710 W MAIN AVE
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City | RITZVILLE
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State | WA
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Zip | 99169-1833
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Country | US
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Telephone | 941-224-1025
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Fax | 509-509-1370
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Provider Business Mailing Address
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Address Line | 710 W MAIN AVE
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City | RITZVILLE
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State | WA
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Zip | 99169-1833
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Country | US
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Telephone | 941-224-1025
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Fax |
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Authorized Official
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Title or Position | DNP
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Name | PATRICIA CRUZ
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Credential | NP
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Telephone | 941-224-1025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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