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General NPI Number Information
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NPI Number | 1194263608
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Entity Type | Organization
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Legal Business Name | KADLEC REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 1351 FOWLER ST
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City | RICHLAND
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State | WA
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Zip | 99352-4714
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Country | US
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Telephone | 509-946-1654
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Fax | 509-943-5652
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Provider Business Mailing Address
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Address Line | 888 SWIFT BLVD
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City | RICHLAND
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State | WA
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Zip | 99352-3514
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Country | US
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Telephone | 509-942-3627
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Fax | 509-942-3295
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Authorized Official
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Title or Position | ASSISTANT SECREATRY FOR ENROLLMENT
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Name | DONALD WAYNE ANDERSON JR.
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Credential |
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Telephone | 425-358-9786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | WA
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